Hyponatraemia, diuretic-induced

Sharabi Y, Ilian R, Kamari Y, Cohen H, Nadler M, Messerli FH, Grossman E. Diuretic induced hyponatraemia in elderly hypertensive women. J Hum Hypertens 2002 16(9) 631-5. 

Jolobe OM. Diuretic-induced hyponatraemia in elderly hypertensive women. J Hum Hypertens 2003 17 151. 

Fernandez P, Choi M. Thiazide-induced hyponatraemia. In Puschett JB, Greenberg A, editors. Diuretics IV Chemistry, Pharmacology and Qinical Applications. Amsterdam Elsevier, 1993 199-209. 

The sulphonylureas, particularly chlorpropamide, may infrequently induce a syndrome of inappropriate secretion of antidiuretic hormone (augmenting hypothalamic-pituitary release of this hormone) characterized by water retention, hyponatraemia, low serum osmolality and high urine osmolality, and central nervous system signs. Water retention and dilutional hyponatraemia have occurred after administration of chlorpropamide and tolbutamide to NIDDM patients, especially those with congestive heart failure or hepatic cirrhosis. Glipizide, acetohexamide (Moses et al., 1973), tolazamide, glibenclamide are mildly diuretic. 

Treatment of oedemalous hyponatraemia is based upon two principles. The underlying condition should be treated, whether that be. for example, heart failure, glomerulonephritis or alcoholic cirrhosis. Excess sodium and water should be reduced by means of a diuretic to induce a natriuresis. and by lluid restriction. 

A case of hyponatraemia resembling anti-diuretic hormone excess induced by phen-formin has been reported (44 ). 

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