Margaret McDougal, M.D., Ph.D. (c) 1997
edited by Michael Gordon, Ph.D.
A 55 year old white male with a history of hypertension for 15 years comes for a second opinion. He indicates that his blood pressure always runs about 100 mm Hg diastolic. He also tells you he has a history of gout in his left knee. He denies any shortness of breath, chest pain, or edema, but does admit to nocturia about twice nightly. He denied taking medication presently.
He was started on 50 mg hydrochlorothiazide (HCTZ, Esidrix, HydroDIURIL)/75 mg triamterene (Dyrenium). He returned two weeks later. BP now 168/100. BUN 60, Creatinine 6.2, K 6.8.
What happened to the patient when he was given hydrochlorothiazide (HCTZ, Esidrix, HydroDIURIL) for his blood pressure? How do you explain the changes in his renal function over the two weeks of treatment?