Effects of hydrochlorothiazide and furosemide on creatinine clearance in some hypertensive Nigerians

Hydrochlorothiazide and furosemide have been reported to alter the glomerular filtration rate (GFR) and possibly the creatinine excretion by the kidneys. Also, therapy with these diuretics, especially in theelderly, can be complicated by volume depletion resulting in prerenal azotemia. Creatinine clearance (Clcr) is considered to be the most accurate test of renal function. Unfortunately, although thesediuretics are widely used in the treatment of hypertension and heart failure in the young and elderly Nigerians, their effects on renal function have been poorly investigated. We, therefore, evaluated theeffects of treatment with 21-day single daily oral doses of 25 mg hydrochlorothiazide or 40 mg furosemide on Clcr in this prospective randomized study of forty Nigerians with mild to moderateuncomplicated essential hypertension (20 males and 20 females) 32 to 80 years of age and 40 age and sex-matched healthy normotensive controls while on their usual diet. Blood and 24 h urine specimenswere collected at baseline and on days 7, 14 and 21. Specimens were assayed for creatinine and the corresponding Clcr for each day was calculated. Analysis of variance did not show a statisticallysignificant effect of the diuretic regimens on Clcr over the period. This study demonstrates that single daily doses of either of these diuretics do not have a significant effect on Clcr over a short-termmonotherapy

Electrolyte profiles in Nigerian patients with essential hypertension

Information is inadequate on the serum and urine electrolyte profiles in Nigerians with mild to moderate essential hypertension. We, therefore, measured the levels of Na+, K+ and Cl- in 40 adult Nigerians withuntreated uncomplicated mild to moderate hypertension and compared these values with those obtained from age and sex-matched normotensives. Electrolytes were measured using ion-selectiveelectrolyte analyzer. Mean arterial pressure (MAP) was 127.20 ± 4.20 mmHg in the hypertensives as compared to 92.27 ± 6.25 mmHg in the normotensives. Both groups of subjects had comparable weightand body mass indices. Results show that in the hypertensives serum, levels of Na+ (152.8 ± 2.14 mmol l-1) and Cl- (115.4 ± 2.62 mmol l-1) were significantly higher than in the normotensives (Na+: 136.0 ± 3.23; Cl-: 102.2 ± 2.52 mmol l-1). Serum K+ levels were significantly lower in the hypertensives than in the normotensives (4.01 ± 0.08 vs 4.82 ± 0.03 mmol l-1). The hypertensives excreted more Na+ (300.9 ± 41.30 mmol l-1) and Cl- (278.6 ± 4.39 mmol l-1) than the normotensives (Na+: 147.10 ± 1.10, Cl-: 126.40 ± 1.51mmol l-1). Urinary K+ level in the hypertensives was significantly higher than in the normotensives (73.70± 0.73 vs 55.60 ± 0.63 mmol l-1). We conclude that mild to moderately hypertensive Nigerians showsignificant differences in their levels of serum and urinary Na+, K+ and Cl- from their normotensive counterparts. The relatively higher serum Na+ and Cl- concentrations and the corresponding lowerserum K+ may indicate their roles in the pathogenesis of hypertension in these patients

Cannabis abuse and addiction: A contemporary literature review

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