Franz M, Hörl W H
Klinischen Abteilung für Nephrologie und Dialyse, Universitätsklinik für Innere Medizin III, Wien.
Wien Med Wochenschr. 1996;146(16):432-5.
Diuretics still remain a cornerstone in the treatment of hypertension. Adverse effects such as disorders of the carbohydrate and lipid metabolism as well as development of hypokalemia or hypomagnesemia are obviously directly correlated to the administered dosage. Therefore, there is increasing agreement for low-dose drug therapy. In contrast to hydrochlorothiazide treatment, metabolic disorders are less commonly encountered with indapamide therapy. A pronounced diuretic efficacy is linked to the combined use of diuretics which act on different segments of the nephron (for example administration of a loop diuretic together with a thiazide). In chronic renal failure indapamide appears to be superior to hydrochlorothiazide considering preservation of renal function. In contrast to thiazides, indapamide is the therapy of choice in patients with diabetes.
利尿剂仍然是治疗高血压的基石。诸如碳水化合物和脂质代谢紊乱以及低钾血症或低镁血症的发生等不良反应显然与给药剂量直接相关。因此，低剂量药物治疗的共识日益增加。与氢氯噻嗪治疗相比，吲达帕胺治疗较少出现代谢紊乱。显著的利尿效果与作用于肾单位不同节段的利尿剂联合使用有关（例如袢利尿剂与噻嗪类利尿剂联合给药）。在慢性肾衰竭中，考虑到肾功能的保留，吲达帕胺似乎优于氢氯噻嗪。与噻嗪类药物不同，吲达帕胺是糖尿病患者的首选治疗药物。
