Clinical Edge

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Hyponatremia almost as common with spironolactone as chlorthalidone

Key clinical point: Spironolactone is more likely than generally thought to cause hyponatremia, and prior hyponatremia on chlorthalidone increases the risk.

Major finding: Forty patients on chlorthalidone developed hyponatremia across 1,322 prescriptions, for an incidence of 3.03%. There were 31 cases across 1,159 spironolactone prescriptions, an incidence of 2.67%.

Study details: Review of over 200 hypertension patients who developed hyponatremia on one diuretic.

Disclosures: There was no external funding, and the investigators didn’t have any industry disclosures.


Matanes F et al. Joint Hypertension 2019, Abstracts 187 and 174.