DIURETICS, CARDIAC FAILURE AND POTASSIUM DEPLETION: A RATIONAL APPROACH

Abstract

This study compares the effectiveness of different diuretic regimes In controlling severe cardiac failure and in preventing potassium depletion. All patients were oedematous while on a thiazide diuretic regimen and despite potassium supplementation showed a gross degree of potassium depletion. Frusemide controlled the cardiac failure, but potassium depletion was still a problem despite potassium supplementation. The addition of amiloride to the frusemide therapy gave better control of the cardiac failure and potassium depletion was not a problem. Moduretic (hydrochlorothiazide plus amiloride) controlled the cardiac failure in most patients and serum and body potassium returned to near normal levels. The most effective way to control the cardiac failure was to reduce sodium intake and when this was done patients with cardiac failure which had previously been difficult to control could now be controlled by digoxin and a low dose of a thiazide diuretic. More attention should be paid to sodium restriction in the treatment of cardiac failure.