Diuretic therapy has pros and cons: it is effective for treating high blood pressure, edema, and specific conditions of the liver and kidneys but can cause side effects. Diuretic therapy definition could be shaped as follows: a treatment method that includes the implementation of diuretics—a specific and complex group of drugs. They can be a powerful tool for doctors aiming to alleviate or treat the patient’s condition. In this material, we will explain diuretic therapy’s benefits and potential drawbacks.
What are Diuretics
Diuretics aka “water pills” are compounds that inhibit the reabsorption of water and salts in kidneys and increase their elimination with urine. In turn, this increases the speed of urine production and frequency of urination. As a result, the amount of certain salts and water in the organs and tissues is reduced.
Who needs diuretics
As you can guess, diuretic therapy can prove very helpful for those patients who have excessive fluids in their tissues due to cardiovascular, kidney, and liver issues. They are also effective for treating edemas—an occurrence when those fluids cause swelling. People who have hypertension (high blood pressure) or congestive heart failure (when the patient’s heart cannot handle the volume of blood and pump it effectively) can also benefit from this medication type.
Pros of Diuretic Therapy
Diuretics are generally safe. Usually, diuretic therapy’s side effects are connected with the loss of water and electrolytes and can be easily managed. Commonly prescribed diuretic drugs are inexpensive, especially when the patient opts for their generic form or uses medical insurance.
When selected by the doctor, diuretics show good results in managing the specific health issue the medical professional and patient are targeting.
Management of fluid overload
Some conditions, both pathological and not, can cause hypervolemia, or fluid overload: when the body retains too much fluid. It can elevate blood pressure, put a lot of pressure on the heart, cause tissue swelling (edema), and affect the operation of all organs and systems, including even the lungs and bowels.
By taking a diuretic, the patient eliminates the excessive fluids with urine, reducing edematous swelling, keeping the symptoms of heart failure under control, etc.
Lowering blood pressure
Because diuretics reduce the total amount of fluids in the organism, they also affect the volume of fluids in your blood vessels and the pressure it causes. Consequently, diuretic therapy causes a drop in blood pressure.
Treatment of specific diseases with diuretic therapy
Acute kidney injury and liver cirrhosis belong to the mentioned pathological conditions that can cause fluid overload. Diuretics are often included in the complex therapy for these conditions. It allows doctors to prevent further fluid accumulation and, at the same time, ease the strain on the organs taking part in fluid metabolism.
Additionally, diuretics are helpful in the case of health issues accompanied or caused by high pressure, such as glaucoma.
Cost-effectiveness
When the patient is okay with generics or has good medical insurance that covers their expenses on medication, diuretics are quite affordable. For example, 30 tablets of furosemide in a dose of 20 mg can cost about $10.
Cons of Diuretic Therapy
Diuretic treatment is not a one-fits-all solution. The patient should only take diuretics following their doctor’s prescription and relevant recommendations.
Side effects
Common side effects of diuretics caused by water loss are:
- Dehydration;
- Constipation;
- Dizziness;
- Headache;
- Erectile dysfunction;
Besides water, diuretics eliminate salts, potentially creating electrolyte disbalance and micronutrients deficiency which can result in:
- Heart palpitations;
- Muscle cramps;
- Gout (increased build-up of uric acid crystals in joints);
- Osteoporosis.
Many diuretic substances have individual side effects. For example, furosemide is ototoxic (can affect your hearing) and captopril can cause a dry cough. All these details are carefully evaluated by your healthcare provider when they develop a treatment plan for you and adjust the dose of medication.
Allergic reactions
Any substance, medical or not, can cause allergic reactions, and diuretics are not exceptional in this regard. If you have been prescribed a diuretic but notice that you develop an allergic reaction, consult a doctor as soon as possible.
Risk of dependence and overuse
Prolonged misuse of diuretics can result in tolerance development so the patient will require to increase the dose of the drug in order to feel its effectiveness. It can also cause dependence on the medication with abrupt stopping resulting in various health issues.
Tips for Safe and Effective Use of Diuretics
When approached responsibly, diuretic therapy will do wonders for your health and will not cause any collateral damage to your health. We listed a couple of things you should remember to make your treatment as safe and beneficial as possible.
Working closely with a healthcare professional
Always listen carefully to your doctor and follow their recommendations. If you need additional information or need to specify or clarify some moments, do not hesitate to ask questions. Remember that successful treatment requires you to work as a team with your healthcare provider.
Regular monitoring
Do not neglect everyday pressure monitoring and regular check-ups so that the doctor can evaluate your kidney function. This is necessary to adjust the dose if needed and avoid possible complications.
Staying hydrated
You do not need to alter specifically the amount of water you drink while on diuretics. Just remember to drink water when you are thirsty. Your body will lose water faster during therapy so not drinking water will cause dehydration much sooner than it normally would.
Managing electrolyte levels through diet or supplements
Keep in mind that diuretics promote the elimination of vital micronutrients, such as calcium, magnesium, or potassium. If you are taking a potassium-sparing diuretic, you can avoid potassium deficiency but do talk with your doctor about the means to maintain your electrolyte levels. You can adjust your diet and add products rich with the elements you need, or take a specific supplement.
Types of Diuretics
Depending on their mechanism of action, diuretics are divided into specific groups that have different indications, side effects, and metabolism.
Thiazide
Thiazide diuretics act in the distal convoluted tubule of the nephron (a structural and functional kidney constituent). They inhibit the reabsorption of the luminal sodium promoting sodium and water excretion with urine. The most common thiazide diuretics are:
- Hydrochlorothiazide;
- Chlorothiazide;
- Indapamide;
- Chlorthalidone;
They are FDA-approved for the treatment of primary hypertension, edema, congestive heart failure, etc.
Loop
Loop diuretics are affecting ion reabsorption in the thick ascending limb of the loop of Henle, hence, the name. Examples of loop diuretics are:
- Bumetanide;
- Torasemide;
- Furosemide
Loop diuretic therapy is FDA-approved for treating conditions of edema associated with congestive heart failure, liver cirrhosis, and renal disease, including nephrotic syndrome.
Potassium-Sparing
As you can guess from the name, potassium-sparing diuretics cause a mild diuretic effect and do not affect potassium levels as much. They work by blocking the sodium reabsorption in the collecting tubule. Commonly used potassium-sparing diuretics are:
- Eplerenone;
- Triamterene;
- Spironolactone
Osmotic
Osmotic diuretics, such as mannitol, increase tubular fluid osmolality and blood flow to the kidneys by drawing water into the collecting ducts and inhibiting its reabsorption.
Such drugs are prescribed for increased intracranial or intraocular pressure (inside the skull or eyes, respectively). They are administered through a venous catheter and are administered only in hospitals.
Summary
Diuretic therapy will cause the body to excrete more salt and water which is helpful for treating issues with hypertension, edema, and heart, kidney, or liver failure. They should be used carefully and under the doctor’s monitoring to manage possible side effects and avoid complications.
FAQ
What are the negatives of diuretics?
Diuretic drugs easily lead to dehydration and electrolyte disbalance which has its own negative consequences. When misused, they can cause dependence.
What are the advantages of diuretic therapy?
Taking diuretics helps the patient to reduce blood pressure and edematous tissue swelling, and alleviate strain on the heart, liver, and kidneys.
Who should avoid diuretics?
These medications are contraindicated for patients who have sodium or potassium deficiency. They are also not suitable for those with hypotension. Pregnant and nursing patients are prescribed diuretics only after evaluation of the risk/benefits ratio.
What are the most frequent adverse effects associated with diuretic therapy?
Diuretic therapy can cause dehydration, headaches, muscle cramps, and electrolyte disbalance.
