 |
 |
The two most recent patients were on lisinopril only with serum sodium of 126 and 122 mmol/L. Clinicians are usually aware of diuretic induced hyponatraemia. Some patients are started on a diuretic for a while however on the addition of ACEI their sodium starts to drop. If the patient is on combination of ACEI and diuretic and develops hyponatraemia we should not assume that the diuretic is the only culprit as it can be an innocent bystander, plenty of cases in the literature support this. regards. --- [log in to unmask] wrote: > It is not uncommon to prescribe diuretics in > combination with ACE-inhibitors; indeed patients > with diabetes and hypertension may well require > triple therapy to reduce their blood pressure to a > UKPDS-based target. Have your patients been on > ACE-inhibitors alone, or are they on other agents as > well? > > Regards, > > Andrew Hutchesson > Royal Bolton Hospital > > ---------- > From: p=NHS NATIONAL > INT;a=NHS;c=GB;dda:RFC-822=acb-clin-chem-gen-request(a)mailbase.ac.uk; > Sent: 17 August 2000 17:43 > To: p=NHS NATIONAL > INT;a=NHS;c=GB;dda:RFC-822=acb-clin-chem-gen(a)mailbase.ac.uk; > Subject: ACE inhibitors - induced hyponatraemia > > Dear Colleagues > > ACEIs are widely prescribed for the treatment of > hypertension, CCF and diabetic nephropathy. > Clinicians > are aware of hyperkalaemia and renal impairment as > side effects of these drugs but are less aware of > hyponatraemia. Increasingly, I have been seeing > cases > of moderate to severe hyponatraemia with > normokalaemia > or mild hyperkalaemia associated with their use. > ACEIs > cause a state of hyper-reninaemic hypoaldosteronism > leading to renal salt wastage. They also cause > water > retention due inappropriate ADH secretion induced > by > raised kinins and brain angiotensin II acting on > the > hypothalamus. Both mechanisms can lead to > hyponatraemia. I would be grateful to share the > experience of colleagues who have noticed a similar > increase in this practical problem. > > regards. > > ===== > Dr. M A Al-Jubouri > Consultant Chemical Pathologist > Whiston Hospital > Prescot > Merseyside L35 5DR > UK > > __________________________________________________ > Do You Yahoo!? > Send instant messages & get email alerts with > Yahoo! Messenger. > http://im.yahoo.com/ > > > > ATTACHMENT part 2 application/ms-tnef ===== Dr. M A Al-Jubouri Consultant Chemical Pathologist Whiston Hospital Prescot Merseyside L35 5DR UK __________________________________________________ Do You Yahoo!? Send instant messages & get email alerts with Yahoo! Messenger. http://im.yahoo.com/ %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%