Potassium-sparing Agents during Diuretic Therapy in Hypertension

The Renin-Aldosterone System and Thiazide-Induced Depletion of Total Body Potassium in Essential Hypertension

“…In some instances a signifi cant body potassium depletion has been docu mented [2,[6][7][8][9], while in others body potassium was normal or only trivially reduced [3][4][5]10,11]. It is interesting and probably significant that the method of estimation of body potas sium content correlated closely to the observed findings.…”

“…O'Meara et al [12] found 40 to 48 h to be the optimal time, while another study [13] showed that in patients undergoing chronic hemodialysis, TEK as the percent TBK was 60.7, 83.6 and 85.9% at 24, 48 and 64 h, re spectively. Studies earlier cited [2,[6][7][8][9], which demonstrated potassium depletion during chronic diuretic therapy, had accepted as adequate an equilibration period of 24-40 h.…”

“…It is interesting and probably significant that the method of estimation of body potas sium content correlated closely to the observed findings. With one exception [5], all the studies [2,[6][7][8][9] which utilized whole body radioisotope dilution technic with 42K (total exchangeable potassium) showed a significant body potas sium depletion, while those studies which uti lized whole body radioisotope counter and measured total body potassium revealed no significant depletion [3,4,10,11], The results of the present study adhere to that trend; our data were obtained by using the whole body counter and they showed no significant deple tion of potassium in the group as a whole. The disparity between the two sets of results ob tained in studies of similar populations seems then to be technical rather than one based on pathophysiology.…”

Total Body Potassium in Long-Term Frusemide Therapy: Is Potassium Supplementation Necessary?

“…The evidence from this study is that when frusemide is given as an adjunct to antihypertensive therapy in non-oedematous patients who are not potassium depleted routine potassium supplements are not required. Also, when potassium supplements are given to patients with normal renal function who are not potassium depleted these are not retained (Bartorelli et al, 1966;Down et al, 1972), which is in contrast to the situation in potassiumdepleted patients in whom retention of potassium supplements has been shown (McKenna et al, 1971).…”

The Diuretic Effect of Bendrofluazide, Alone and With Triamterene

“…Previous studies have suggested triamterene does counteract the hypokalaemic effects of the short acting frusemide (8) but does not reduce the potassium loss caused by the long acting diuretic, chlorthalidone (9). It is possible to speculate, therefore, that it might be usefully combined with a shorter acting diuretic or should be given in a slow release form or twice daily.…”