Evidence map›Paper›PMID 38980794›Full record

ArticleThe Permanente journal2024

Thiazide Discontinuation in Chronic Kidney Disease Hypertension Management: A Retrospective Chart Review.

Kirsten Dalangin Vea, Leigh Anh Nguyen, Kristine McGill, Jong C Park, David Selevan

Abstract readMulticenter Study
In one paragraph

Article in The Permanente journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kirsten Dalangin VeaPharmacy Administration, Kaiser Permanente West Los Angeles Medical Center, Los Angeles, CA, USA.ORCID 0009-0003-2797-2344
Leigh Anh NguyenDepartment of Nephrology, Kaiser Permanente West Los Angeles Medical Center, Los Angeles, CA, USA.
Kristine McGillPharmacy Administration, Kaiser Permanente West Los Angeles Medical Center, Los Angeles, CA, USA.
Jong C ParkDepartment of Nephrology, Kaiser Permanente West Los Angeles Medical Center, Los Angeles, CA, USA.
David SelevanRenal Business Group, Southern California Permanente Medical Group, Pasadena, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThiazides are utilized in general hypertension management, however, their role in chronic kidney disease (CKD) hypertension management remains unclear. Although data support thiazide efficacy in advanced CKD, the adverse effect profile (including estimated glomerular filtration rate [eGFR] decline and electrolyte abnormalities) may lead to thiazide discontinuation. The authors assessed the thiazide discontinuation rate in Kaiser Permanente Southern California members with moderate-to-severe CKD and hypertension.

methodsThis study was a multicenter retrospective analysis evaluating Kaiser Permanente Southern California members with hypertension and CKD 3B or 4 who filled a thiazide prescription in 2021, with follow-up through 2022. The outcomes were thiazide discontinuation rate, reason for thiazide discontinuation, time to thiazide discontinuation, and discontinuing practitioner specialty. Mean changes in blood pressure and eGFR from baseline were also evaluated.

resultsOf the 401 patients followed for 1 year after thiazide initiation, 65 patients discontinued a thiazide (discontinuation rate: 16.2%, mean time to discontinuation: 7.5 months). Of the 201 patients followed for 2 years after thiazide initiation, 57 patients discontinued a thiazide (discontinuation rate: 28.4%, mean time to discontinuation: 15.5 months). The most commonly documented thiazide discontinuation reason was increased serum creatinine (30% of total reasons at 1 year and 39% of total reasons at 2 years).

conclusionMost patients with hypertension and CKD 3B or 4 continued on a thiazide with favorable blood pressure lowering effects and modest eGFR decline. Thiazides may be considered viable antihypertensive options with close renal function monitoring for patients with moderate-to-severe CKD.

Indexed as

Glomerular Filtration RateHypertensionRenal Insufficiency, ChronicThiazidesAgedAntihypertensive AgentsBlood PressureCaliforniaFemaleHumansMaleMiddle AgedRetrospective StudiesSodium Chloride Symporter InhibitorsAntihypertensive AgentsSodium Chloride Symporter InhibitorsThiazideshypertensionnephrologypharmacistrenal

Identifiers

PMID38980794
PMCPMC11404643

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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.