Clinical study of a new diuretic, hydrochlorithiazide: modification of water and electrolyte balance in patients with and without edema

Abstract

SummaryIn the first part of this study, doses of 50 mgr/day of hydrochlorothiazide were administered per os to 8 hypertensive patients without edema. The metabolic studies realized show, after 4 days of treatment, a negative sodium balance, an augmentation of the urinary elimination of potassium and chloride, a reduction of weight and extracellular spaces, and finally a negative water balance, without necessarily an increase in diuresis. The sodium loss corresponds to a diminution of the extracellular reserve of sodium; in contrast the reduction of the extracellular reserve of potassium only explains 20 to 30 % of the potassium lost by the urinary pathway. In all the cases there is a definite modification of the blood electrolytes with tendency towards hypochloremic alkalosis and hypokalemia from the 4th day.In the second part of the work, the effect of hydrochlorothiazide was studied in subjects presenting very important cardiac or cirrhotic edema. The edema regressed in many cases (sometimes after a lat...