SynthesisBritish journal of clinical pharmacology2015
A systematic review and meta-analysis of thiazide-induced hyponatraemia: time to reconsider electrolyte monitoring regimens after thiazide initiation?
Synthesis in British journal of clinical pharmacology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.
What it found
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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.
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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.
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Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Effectiveness and safety of chronic diuretic use in older adults: an umbrella review of recently published systematic reviews and meta-analyses of randomized-controlled trials.European geriatric medicine · 2025Pooled it
- The effects of diuretic deprescribing in adult patients: A systematic review to inform an evidence-based diuretic deprescribing guideline.British journal of clinical pharmacology · 2025Pooled it
- Major electrolyte disorder and associated factors among patients with chronic disease in Ethiopia: a systematic review and meta-analysis.BMC nephrology · 2024Pooled it
- Minimally Symptomatic Severe Hyponatremia: Two Case Reports.Clinical practice and cases in emergency medicine · 2026Article
- Thiazides and Risk of Hyponatremia by Age and Sex.JAMA network open · 2026Article
- A control theoretic primer for systems endocrinology.Frontiers in endocrinology · 2026Review
- Hyponatraemia in ageing.Nature reviews. Endocrinology · 2025Review
- Evaluation of hyponatremia among older adults exposed to selective serotonin reuptake inhibitors and thiazide diuretics.Pharmacotherapy · 2025Article
- The Effect of Thiazide Diuretics on Urinary Prostaglandin E2 Excretion and Serum Sodium in the General Population.The Journal of clinical endocrinology and metabolism · 2024Article
- [Consensus recommendations on the diagnosis and treatment of hyponatremia from the Austrian Society for Nephrology 2024].Wiener klinische Wochenschrift · 2024Article
- Women have a higher risk of hospital admission associated with hyponatremia than men while using diuretics.Frontiers in pharmacology · 2024Article
- Thiazide-associated hyponatremia increases the risk of major adverse cardiovascular events among elderly Taiwanese patients.BMC geriatrics · 2023Article
- Developing a Warning Model of Potentially Inappropriate Medications in Older Chinese Outpatients in Tertiary Hospitals: A Machine-Learning Study.Journal of clinical medicine · 2023Article
- Hyponatremia in patients with arterial hypertension: pathophysiology and management.Archives of medical science : AMS · 2023Article
- Antihypertensive Drugs and Risk of Bone Fractures.Drugs & aging · 2022Review
- Do medicines commonly used by older adults impact their nutrient status?Exploratory research in clinical and social pharmacy · 2021Review
- Time-dependent association between selective serotonin reuptake inhibitors and hospitalization due to hyponatremia.Journal of psychopharmacology (Oxford, England) · 2021Article
- Increased Mortality in Elderly Patients Admitted with Hyponatremia: A Prospective Cohort Study.Journal of clinical medicine · 2021Article
- Association between newly initiated thiazide diuretics and hospitalization due to hyponatremia.European journal of clinical pharmacology · 2021Article
- Article
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 2 countries.
Funding
Abstract
aimsHyponatraemia is one of the major adverse effects of thiazide and thiazide-like diuretics and the leading cause of drug-induced hyponatraemia requiring hospital admission. We sought to review and analyze all published cases of this important condition.
methodsOvid Medline, Embase, Web of Science and PubMed electronic databases were searched to identify all relevant articles published before October 2013. A proportions meta-analysis was undertaken.
resultsOne hundred and two articles were identified of which 49 were single patient case reports. Meta-analysis showed that mean age was 75 (95% CI 73, 77) years, 79% were women (95% CI 74, 82) and mean body mass index was 25 (95% CI 20, 30) kg m(-2) . Presentation with thiazide-induced hyponatraemia occurred a mean of 19 (95% CI 8, 30) days after starting treatment, with mean trough serum sodium concentration of 116 (95% CI 113, 120) mm and serum potassium of 3.3 (95% CI 3.0, 3.5) mm. Mean urinary sodium concentration was 64 mm (95% CI 47, 81). The most frequently reported drugs were hydrochlorothiazide, indapamide and bendroflumethiazide.
conclusionsPatients with thiazide-induced hyponatraemia were characterized by advanced age, female gender, inappropriate saliuresis and mild hypokalaemia. Low BMI was not found to be a significant risk factor, despite previous suggestions. The time from thiazide initiation to presentation with hyponatraemia suggests that the recommended practice of performing a single investigation of serum biochemistry 7-14 days after thiazide initiation may be insufficient or suboptimal. Further larger and more systematic studies of thiazide-induced hyponatraemia are required.
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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.