Thiazide Hyponatraemia — ESENeph MCQ

Correct answer: D — Thiazide-like diuretic-associated hypotonic hyponatraemia

The best answer is “Thiazide-like diuretic-associated hypotonic hyponatraemia”. Indapamide is a thiazide-related diuretic that can cause clinically important hyponatraemia, sometimes initially asymptomatic. Plasma sodium should be measured before treatment and at regular intervals, and the medicine and other contributors are reviewed when hyponatraemia occurs. “Pseudohyponatraemia caused by indapamide-induced hyperlipidaemia” is less appropriate because indapamide directly causes true water-electrolyte disturbance rather than this laboratory artefact “Hypernatraemia from excessive distal sodium reabsorption” is less appropriate because the measured abnormality and recognised diuretic effect are in the opposite direction “Primary hyperaldosteronism induced by indapamide” is less appropriate because the medicine does not cause an autonomous adrenal disorder and this would not explain the sodium pattern “Acute glomerulonephritis caused by indapamide” is less appropriate because there is no nephritic urine or kidney-function pattern to support glomerulonephritis

Reference: Indapamide 2.5 mg Summary of Product Characteristics: https://www.medicines.org.uk/emc/product/14345/smpc