What are the benefits and risks of using diuretics in patients with chronic kidney disease?
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The risk of cardiovascular disease (CVD) and heart failure is lower with thiazide diuretics compared with other antihypertensive agents in patients with a glomerular filtration rate (GFR) <60 mL/min/1.73m2 (SOR: B, based on a single RCT). Loop diuretics are associated with an increased risk of secondary hyperparathyroidism, an effect not seen with thiazides. Lower potassium levels are associated with higher mortality (SOR: C, based on cohort study of disease-oriented outcomes).
Evidence Based Practice 16(6): 12.