ReviewCurrent opinion in nephrology and hypertension2008
Do thiazides worsen metabolic syndrome and renal disease? The pivotal roles for hyperuricemia and hypokalemia.
Review in Current opinion in nephrology and hypertension, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- The Effect of Tolvaptan on Metabolism and Electrolyte Homeostasis in Patients with Heart Failure: A Systematic Review and Meta-Analysis.Reviews in cardiovascular medicine · 2024Pooled it
- Elevated prevalence of abnormal glucose metabolism in patients with primary aldosteronism: a meta-analysis.Irish journal of medical science · 2014Pooled it
- Effect of losartan combined with amlodipine or with a thiazide on uric acid levels in hypertensive patients.Therapeutic advances in cardiovascular disease · 2017Trial
- Hyperuricemia in Chinese Patients with Mood Disorders: Prevalence, Related Factors, and Predictive Model.Neuropsychiatric disease and treatment · 2025Article
- Acetazolamide and Hydrochlorothiazide in Patients With Acute Decompensated Heart Failure: Insights From Recent Trials.Cardiology research · 2024Review
- Metabolic Alkalemia in Hypercalciuria Stone Formers: Does It Matter?Kidney & blood pressure research · 2024Article
- Fructose might be a clue to the origin of preeclampsia insights from nature and evolution.Hypertension research : official journal of the Japanese Society of Hypertension · 2023Review
- Thiazides in chronic kidney disease: "back to the future".Clinical kidney journal · 2023Article
- Article
- Anthropometric variables, physical activity and dietary intakes of patients with uric acid nephrolithiasis.Urolithiasis · 2020Observational
- Hyperuricemia, Acute and Chronic Kidney Disease, Hypertension, and Cardiovascular Disease: Report of a Scientific Workshop Organized by the National Kidney Foundation.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2018Review
- Gout in immigrant groups: a cohort study in Sweden.Clinical rheumatology · 2017Article
- Perspective: A Historical and Scientific Perspective of Sugar and Its Relation with Obesity and Diabetes.Advances in nutrition (Bethesda, Md.) · 2017Review
- Plasma potassium, diuretic use and risk of developing chronic kidney disease in a predominantly White population.PloS one · 2017Article
- Metabolic syndrome and chronic kidney disease: Current status and future directions.World journal of nephrology · 2014Review
- Improving cardiovascular and renal outcomes in gout: what should we target?Nature reviews. Rheumatology · 2014Review
- Potassium intake and the prevalence of metabolic syndrome: the Korean National Health and Nutrition Examination Survey 2008-2010.PloS one · 2013Article
- Hypokalemia, its contributing factors and renal outcomes in patients with chronic kidney disease.PloS one · 2013Article
- Which diuretic is the preferred agent for treating essential hypertension: hydrochlorothiazide or chlorthalidone?Current cardiology reports · 2012Review
- Comparison of effects of azelnidipine and trichlormethiazide in combination with olmesartan on blood pressure and metabolic parameters in hypertensive type 2 diabetic patients.Journal of diabetes investigation · 2011Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
Abstract
purpose of reviewThe aims of this article are to review the current controversies related to the use of thiazide diuretics as first-line treatment of hypertension and to discuss the causal roles for hyperuricemia and hypokalemia on the adverse consequences of thiazide usage. RECENT
findingsThiazides significantly reduce morbidity and mortality in hypertensive subjects. There remains, however, debate about thiazide usage as first-line treatment of hypertension. This negative impact of thiazides may be partially attributed to the ability of thiazides to exacerbate features of metabolic syndrome or increase the risk for developing diabetes. Several clinical trials suggest that thiazide-induced hyperuricemia and hypokalemia may account for some of these negative effects. Thiazide treatment is also associated with a decline of renal function in spite of a lowering blood pressure. In this review, we discuss the clinical and experimental evidence supporting a potential role of hyperuricemia and hypokalemia on the development of renal injury and worsening of the metabolic syndrome. SUMMARY: Hyperuricemia and hypokalemia may have pivotal roles in the exacerbation of the metabolic syndrome in response to thiazides. We propose that controlling serum uric acid and serum potassium could improve thiazide efficacy and also reduce its risk for inducing metabolic syndrome or diabetes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.