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Thiazides (and thiazide-like diuretics such as chlorthalidone) have various electrolyte-related and metabolic adverse effects, and they can cause symptomatic volume depletion in patients with low fluid intake. In this study of emergency department visits to a single general hospital during a recent 2-year period, Swiss researchers examined the prevalence of syncope, falls, and electrolyte abnormalities in patients who were taking thiazide diuretics.
About 8% of 65,000 patients were taking daily thiazides (mostly hydrochlorothiazide). Thiazide users were significantly more likely than nonusers to present with acute kidney injury (21% vs. 7%), hyponatremia (22% vs. 10%), hypokalemia (19% vs. 11%), recent falls (21% vs. 7%), and recent syncope …