[Long-term diuretic treatment in nursing home residents. Is discontinuation possible?].

In this study the need for long-term diuretic therapy was investigated in nursing home patients. In 24 patients the need for diuretics was reassessed and the therapy was discontinued if possible. In 17 of the 24 patients therapy was discontinued. There was a follow-up of 17 days. Four patients developed congestive heart failure, and one patient died during the observation period after a series of complicating events. In the remaining 12 patients therapy had been discontinued successfully. Their mean body weight rose with 0.5 kg, and there were no significant changes in physical examination, serum creatinine, urea, potassium and hematocrit. It was concluded that it was possible in a substantial part of the population studied to discontinue diuretics, when there was no obvious current indication for this treatment. Careful clinical observation is needed to guarantee early detection of (recidive of) congestive heart-failure or hypertension.