Effects of diuretics furosemide and hydrochlorothiazide on CKD-MBD: A prospective randomized study
Raquel F.V. Vasco,
Liliam Takayama,
Rosa M.R. Pereira,
Rosa M.A. Moyses,
Rosilene M. Elias
Affiliations
Raquel F.V. Vasco
Department of Medicine, Renal Division, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil; Corresponding author at: Faculdade de Medicina da Universidade de São Paulo, Serviço de Nefrologia, Rua Dr. Enéas de Carvalho Aguiar 255, 7° andar, São Paulo CEP 05403-000, SP, Brazil.
Liliam Takayama
Department of Medicine, Rheumatology Division, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
Rosa M.R. Pereira
Department of Medicine, Rheumatology Division, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
Rosa M.A. Moyses
Department of Medicine, Renal Division, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
Rosilene M. Elias
Department of Medicine, Renal Division, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil; Universidade Nove de Julho, UNINOVE, São Paulo, Brazil
Although diuretics are often prescribed to control fluid overload, they can change Chronic kidney disease-mineral and bone disorder (CKD-MBD) parameters. Previous studies have shown an association between diuretic prescription and changes in both calciuria and parathormone levels. However, the causal relationship could not be confirmed. In addition, the effects of diuretics on bone mineral density and turnover markers are yet to be established. To evaluate the effects of diuretics on CKD-MBD, we have performed a prospective randomized trial comparing hydrochlorothiazide with furosemide in a stage 3CKD population followed for 1 year. Furosemide increased bone remodeling and parathormone levels, whereas hydrochlorothiazide attenuated parathyroid hormone rise and decreased bone turnover markers.
