Abstract
The effects of treatment with hydrochlorothiazide (50-75 mg/day p.o.) combined with amiloride (10-15 mg/day p.o.) were compared to hydrochlorothiazide (HCTZ) treatment alone in two brothers, aged 12 and 19 years, with nephrogenic diabetes insipidus. Whereas, both modalities of treatment resulted in reduction in voiding frequency and urine volume, decrease in daily fluid intake and increase in urine osmolality, the two-drug combination was found to be superior to HCTZ alone by preventing urinary potassium losses, hypokalemia and alkalosis. During admission of 3 weeks, it was also found that amiloride has an additive effect to the thiazide in terms of increasing initial urinary sodium excretion, reducing urine volume and free water clearance and lowering serum sodium and osmolality.
As evaluated by the above variables, in an additional study in the younger brother, HCTZ-amiloride showed a slight advantage over HCTZ-tolmetin.
Treatment of the two patients for 10 months with HCTZ-amiloride showed no adverse effects and consistent reduction in fluid intake and urine volume. It is concluded that the HCTZ-amiloride regimen is a satisfactory alternative treatment of nephrogenic diabetes insipidus.
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Alon, U., Chan, J. HYDROCHLOROTHIAZIDE-AMILORIDE IN NEPHROGENIC DIABETES INSIPIDUS. Pediatr Res 18 (Suppl 4), 358 (1984). https://doi.org/10.1203/00006450-198404001-01591
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DOI: https://doi.org/10.1203/00006450-198404001-01591