Which diuretics are not recommended with a CrCl below 30 mL min?
Evidence-based guidelines that included recommendations about diuretic selection in individuals with reduced renal function suggest that thiazide diuretics should not be used in individuals with CLcr of less than 30mL/min or who have serum creatinine above 200 mcmol/L, and state that loop diuretics could be used.
What is CrCl 30 mL min?
Creatinine clearance values of 30 to 40 mL/min/1.73 m2 suggest moderate renal impairment, while values <28 suggest severe impairment. Creatinine clearance may not be accurate in the following medical conditions. Specimen requirement is a twenty‑four hour urine collection in a container without preservative.
Can hydrochlorothiazide lower eGFR?
Both studies compared and verified the therapeutic effects when amlodipine (a CCB) or hydrochlorothiazide (HCTZ) (a diuretic) was concomitantly used with ACEI. Although HCTZ reduced albuminuria in both studies, there was also a large decline in the estimated glomerular filtration rate (eGFR).
Can hydrochlorothiazide cause high creatinine levels?
Hydrochlorothiazide (HCTZ) is a diuretic and may cause a slight elevation in the serum creatinine as your blood pressure falls.
What is creatinine clearance?
Definition. The creatinine clearance test helps provide information about how well the kidneys are working. The test compares the creatinine level in urine with the creatinine level in blood.
What is normal creatinine clearance mL min?
Normal Results Clearance is often measured as milliliters per minute (mL/min) or milliliters per second (mL/s). Normal values are: Male: 97 to 137 mL/min (1.65 to 2.33 mL/s). Female: 88 to 128 mL/min (14.96 to 2.18 mL/s).
Does hydrochlorothiazide increase potassium?
Thiazide diuretics like hydrochlorothiazide (Esidrix, HydroDIURIL, other brands) continue to be a very effective way to lower blood pressure for people with hypertension.
How does HCTZ affect the kidneys?
Hydrochlorothiazide, often called HCTZ, acts on the kidney filtration system, which determines which salts get excreted in the urine and which stay in the body. HCTZ prevents the kidneys from reabsorbing sodium and chloride ions, allowing them to be removed in the urine.
What should you assess before giving hydrochlorothiazide?
Examination and Evaluation
- Monitor signs of fluid, electrolyte, or acid-base imbalances, including dizziness, drowsiness, blurred vision, confusion, hypotension, or muscle cramps and weakness.
- Assess dizziness and weakness that might affect gait, balance, and other functional activities (See Appendix C).
Is hydrochlorothiazide safe for kidneys?
Hydrochlorothiazide can aggravate kidney dysfunction and is used with caution in patients with kidney disease. Hydrochlorothiazide can lower blood potassium, sodium, and magnesium levels.