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Kidney Diseases

Diuretics and Kidney

05/11/2009

Question:

Can you tell me how kidney dysfunction relates to diuretic resistance. That is if my kidney function is a little bit reduced (creatinine around 1.5) is diuretic resistance still possible? Will continuing to increase diuretic dose in attempt to work, hasten kidney damage? As well, is creatinine and GFR (?) a good measure of kidney fuction? Thank you.

Answer:

Serum creatinine is a good measure of kidney function and is used to calculate the GFR. The worse your kidney function the more diuretic you will need to achieve the same effect. The diuretic itself does not usually cause kidney malfunction unless too much is given and the you get dehydrated. The doctor adjusts the dose of the diuretic based on the desired effect and can monitor overshooting the desired dose by seeing if the kidney function changes. If the kidney function changes as a result of overshooting the dose, this change is reversible if managed in a timely fashion (days to weeks).

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Response by:

Thomas   Zipp, MD Thomas Zipp, MD
Assistant Professor of Medicine
School of Medicine
Case Western Reserve University