Work

The urine metabolomic signature of distal diuretics and diuretic-induced hyponatremia in patients with chronic kidney disease

Year: 2026

Type: article

Abstract: We assessed the urinary metabolomic fingerprint of treatment with amiloride and hydrochlorothiazide in individuals with CKD stages G3-G4. We identified enhanced ammoniagenesis in the absence of hypokalemia or metabolic acidosis. Patients who developed diuretic-induced hyponatremia exhibited a urinary metabolomic signature of oxidative stress. Our study highlights the interplay between "electrolyte and fluid balance" and "metabolic adaptations" in individuals with CKD who are treated with distal diuretics.

Source: American Journal of Physiology-Renal Physiology

DOI: 10.1152/ajprenal.00431.2025

Authors: Crissy F. Rudolphi, Usha Musterd-Bhaggoe, George J. G. Ruijter, Ewout J. Hoorn, Pedro H. Imenez Silva

Institution: Erasmus MC

Language: English

Topic: Electrolyte and hormonal disorders

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Funder: Nierstichting