Effect of diuretics on sodium, potassium and chloride levels- a cross sectional study

Background: Diuretics are one of the widely used class of drugs used in various cardiovascular and other disorders. However, they can cause various metabolic adverse effects, electrolyte imbalance being among important changes.Methods: A cross sectional study was conducted in which patients diagnosed with hypertension for at least one month were included. Over a period of 6 months patients were enrolled irrespective of whether they were taking diuretics or not. Demographic details, drug therapy and electrolyte levels were recorded in a proforma. Data was analyzed for difference in serum electrolyte levels between diuretic and nondiuretic groups as well as between different diuretic groups.Results: Out of total 177 participants, 71 were on diuretic therapy. There was significant difference in mean serum sodium (S. Na), potassium (S. K) and chlorine (S. Cl) levels between diuretic and nondiuretic groups (P<0.05). Hyponatremia, hypokalemia and hyperkalemia were observed. Thiazide diuretic group showed significantly greater hyponatremia compared to other diuretics (P=0.028). Hyperkalemia was observed in participants receiving K sparing diuretic or combination of loop and K sparing diuretics. Old age and number of comorbidities showed negative association with S. Na. Females had significantly more hyponatremia than male participants.Conclusions: The study confirms that diuretics cause various abnormalities in electrolytes namely Na and K levels. Old age, comorbidities and female sex are risk factors for hyponatremia.