Greenberg · The American journal of the medical sciences 2000 · narrative literature review · n=?

Diuretic complications.

Cited 152 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review of literature and clinical trials without systematic search methodology

PubMed 10653441 · record verified 2026-08-29

What was done

The author conducted a narrative review of literature and large-scale hypertension trials examining diuretic use, focusing on reports of side effects, underlying renal mechanisms, and adverse clinical outcomes across different diuretic classes.

What was found

The abstract reports no quantitative figures or incidence rates. It notes that loop and thiazide diuretics typically cause volume depletion, prerenal azotemia, hypokalemic hypochloremic metabolic alkalosis, hyponatremia, and hyperuricemia. Thiazides are associated with glucose intolerance and severe hyponatremic neurologic damage, while loop diuretics can cause ototoxicity. Potassium-sparing agents and carbonic anhydrase inhibitors frequently cause metabolic acidosis, with potassium-sparing drugs posing significant hyperkalemia risk. Reported idiosyncratic reactions include interstitial nephritis, noncardiogenic pulmonary edema, pancreatitis, and myalgias.

Why it matters

It organizes the spectrum of diuretic-induced complications around each drug class's specific site of action in the kidney, providing a mechanistic framework to monitor and manage electrolyte imbalances.

Limits

The paper is a non-systematic narrative review with no defined search criteria, quality appraisal of included studies, or quantitative pooling. The abstract provides no numerical risk estimates or event rates.

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