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  • Title: Do diuretics have antihypertensive properties independent of natriuresis?
    Author: Bennett WM, McDonald WJ, Kuehnel E, Hartnett MN, Porter GA.
    Journal: Clin Pharmacol Ther; 1977 Nov; 22(5 Pt 1):499-504. PubMed ID: 334435.
    Abstract:
    To ascertain whether diuretics have an antihypertensive effect independent of natriuresis, 12 stable patients on maintenance hemodialysis underwent a crossover evaluation with hydrochlorothiazide, 50 mg daily, metolazone, 5 mg daily, or placebo in 4-wk treatment periods for 6 mo. Compliance was assured by pill counts and serum drug concentrations. All patients had daily urine less than 100 ml. Pre- and postdialysis blood pressure, body weight, plasma volume, and plasma renin activity were monitored. Over the 6-mo study period there were no statistically significant changes in any parameter related to diuretic therapy. It is concluded that a functioning kidney with the ability to respond to diuretics with a natriuresis is necessary for the antihypertensive action of diuretics. Direct vascular effects of diuretics to lower peripheral resistance could not be demonstrated in this unique patient population.
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