Response of thiazide-induced hypokalemia to amiloride
R. F. Maronde, M. Milgrom, N. D. Vlachakis and L. Chan
The effects of amiloride hydrochloride on thiazide-induced hypokalemia were
evaluated. In metabolic balance studies, amiloride reversed
thiazide-induced urinary potassium loss, restored plasma bicarbonate
concentration and pH to pretreatment levels, and produced further increases
in aldosterone secretion. Effects of long-term administration of
hydrochlorothiazide and an amiloride-hydrochlorothiazide combination were
compared in outpatients who had experienced thiazide-induced hypokalemia
while receiving oral potassium supplements. After eight weeks, those given
hydrochlorothiazide alone had an average serum potassium level of 3.01 +/-
0.08 mEq/L). Those given the amiloride-hydrochlorothiazide combination had
an average serum potassium level of 3.75 +/- 0.008 mEq/L, not significantly
different from the control value (3.82 +/- 0.08 mEq/L). Both groups had
increased plasma aldosterone concentrations and plasma renin activity. The
potassium-conserving effect of amiloride persisted with extended therapy.
