DIURETIC ABUSE: A NEPHROLOGIST’S VIEW
- Authors: Prokopenko E.1, Budnikova N.1
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Affiliations:
- M.F. Vladimirsky Moscow Regional Clinical Research Institute
- Issue: Vol 23, No 6 (2012)
- Pages: 12-16
- Section: Articles
- URL: https://journals.eco-vector.com/0236-3054/article/view/115408
- ID: 115408
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Abstract
Diuretic abuse is frequently observed in individuals who strictly control their weight, in young women in particular. Patients with anorexia nervosa often use diuretics and laxatives to detoxify the body. The uncontrolled use of diuretics (commonly in large doses) is associated with serious somatic abnormalities, such as secondary hyperaldosteronism, electrolyte imbalance, pseudoidiopathic edemas, secondary gout, osteoporosis, and interstitial nephritis. Diuretic abuse should be differentiated from Gitelman’s syndrome, Bartteґs syndrome, and idiopathic edemas. The basis for treatment for diuretic abuse is psychiatric care and diuretic discontinuation via spironolactone suppression of renin-angiotensin-aldosterone system activity.
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About the authors
E. Prokopenko
M.F. Vladimirsky Moscow Regional Clinical Research Institute
Email: renalnephron@gmail.com
MD Moscow
N. Budnikova
M.F. Vladimirsky Moscow Regional Clinical Research Institute
Email: renalnephron@gmail.com
Candidate of Medical Sciences Moscow
References
- Бернхейм Ж., Галит Х., Зеев К., Поджарны Э. Избыточное накопление жидкости у пациентки, хронически злоупотребляющей слабительным: «псевдоидиопатические» отеки // Нефрол. и диализ. - 2003; 5(1): 87-8.
- Рейманн Д., Гросс П. Хроническая труднодиагносцируемая гипокалиемия // Нефрол. и диализ. - 2002; 4 (2): 131-3.
- Aravena C., I. Salas I., Tagle R. et al. Hipokalemia, hipovolemia y repercusion electrocardiografica secundarias a ingesta prolongada de furosemida. Caso clinico // Rev. Med. Chile. - 2007; 135: 1456-62.
- Cadwallader A., de la Torre X., Tieri A. et al. The abuse of diuretics as performance-enhancing drugs and masking agents in sport doping: pharmacology, toxicology and analysis // Brit. J. Pharm. - 2010; 161: 1-16.
- Derman O., Kilic E. Edema can be a handicap in treatment of anorexia nervosa // Turk. J. Pediatr. - 2009; 51 (6): 593-7.
- Gill J., Waldmann T., Bartter F. Idiopathic edema. I. The occurrence of hypoalbuminemia and abnormal albumin metabolism in women with unexplained edema // Am. J. Med. - 1972; 52: 444-51.
- Gitelman H., Graham J., Welt L. A familial disorder characterized by hypokalemia and hypomagnesemia // Ann. NY Acad.Sci. - 1969; 162: 856-64.
- Guay-Woodford L. Bartter sindrome: unraveling the pathophysiologic enigma // Am. J. Phys. - 1998; 105: 151-61.
- Kuchel O., Buu N., Racz K. et al. Hormonal correlates of the inadequate natriuretic response to salt loading inidiopathic edema // Clin. Invest. Med. - 1987; 10 (2): 71-7.
- Kuchel O., Ethier J. Extreme diuretic dependence in idiopathic edema: mechanisms, prevention and therapy // Am. J. Nephrol. - 1998; 18 (5): 456-9.
- Kuchel O., Hochy K., Gregorova I. et al. Inappropriate response to upright posture: A precipitating factor in the pathogenesed of idiopathic edema // Ann. Intern. Med. - 1970; 73: 245-52.
- Liamis G., Mitrogianni Z., Liberopoulos E. et al. Electrolyte disturbances in patients with hyponatremia // Intern. Med. - 2007; 46 (11): 685-90.
- Lunow M., Adam B., Seidel G. Pseudo-Conn's syndrome with hypokalemic paralysis due to diuretics and licoriceabuse // Fortschr. Neurol. Psychiatr. - 2011; 79(1): 46-50.
- MacGregor G., Markandu N., Roulston J. et al. Is «idiopathic» oedema idiopathic? Lancet. - 1979; 1 (8113): 397-400.
- MacGregor G., Tasker P., de Wardener H. Diuretic-induced oedema // Lancet. - 1975; 1 (7905): 489-92.
- Mascolo M., Chu E., Mehler P. Abuse and clinical value of diuretics in eating disorders therapeutic applications // Int. J. Eat. Disord. - 2011; 44 (3): 200-2.
- Meyers A., Feldman C., Sonnekus M. et al. Chronic laxative abusers with pseudo-idiopathic oedema and autonomous pseudo-Bartter's syndrome // S. Afr. Med. J. - 1990; 78: 631-6.
- Ota K., Kimura T., Matsui K. et al. The effects of postural changes on ADH release and the renal handling of sodium and water in patients with idiopathic edema // Endocrinol. Japon. - 1984; 31 (4): 459-69.
- Park C., You H., Kim Y. et al. Chronic tubulointerstitial and distal renal tubular acidosis in a patients with frusemide abuse // Nephrol. Dial. Transplant. -2001; 16: 867.
- Pascual E., Perdiguero M. Gout, diuretics and the kidney // Ann. Rheum. Dis. - 2006; 65: 981-2.
- Schepkens H., Hoeben H., Vanholder R., Lameire N. Mimicry of surreptitious diuretic ingestion and the ability to make a genetic diagnosis // Clin. Nephrol. -2001; 55 (3): 233-7.
- Simon D., Nelson-Williams C., Bia M. et al. Gitelman's variant of Bartter's syndrome: inherited hypokalemia is caused by mutations in the thiazide sensitive Na/Cl cotransporter NKCC2 // Nature Genet. - 1996; 13: 183-8.
- Sims E., Mackay B., Shirai T. The relation of capillary angiopathy and diabetes mellitus to idiopathic edema // Ann. Intern. Med. - 1965; 63: 972-87.
- Streeten D., Dalkos T., Souman M. et al. Studies of the pathogenesis of idiopathic edema; The roles of postural changes in plasma volume, plasma renin activity, aldosterone secretion rate and glomerular filtration rate in the retention of sodium and water // Clin. Sci. Mol. Med. - 1973; 45: 347-73.
- Vu T., Wong R., Hamblin P. et al. Patients Presenting with Severe Hypotonic Hyponatremia: Etiological Factors, Assessment, and Outcomes // Hosp. Pract. (Minneap.). - 2009; 37 (1): 128-36.
- Waller P., Ramsay L. Predicting acute gout in diuretic-treated hypertensive patients // J. Hum. Hypertens. - 1989; 3: 457-61.
- Witz L., Shapiro M., Shenkman L. Chlorpromazine induced fluid retention masquerading as idiopathic oedema // Brit. Med. J. - 1987; 294: 807-8.
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