How Common Is Hyponatremia with Thiazides?

Thiazide diuretics are known to increase a patient’s risk of hyponatremia (Figure 1), but the absolute risk is not well characterized. To address this gap, researchers analyzed a Swedish population database, quantifying hyponatremia risk among 80,000 people starting thiazides and 80,000 matched controls starting calcium-channel blockers (CCBs). Notably, this analysis did not include the thiazide-like diuretic chlorthalidone; it included only hydrochlorothiazide and bendroflumethiazide, a drug not available in the United States.