Long-Term Use of Diuretics: Impact on Kidney Health and Proteinuria - Urology

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Long-term use of diuretics, such as the one you mentioned (適尿通), can have various effects on kidney health, particularly in individuals with pre-existing kidney conditions. Diuretics are commonly prescribed to manage conditions such as hypertension, heart failure, and edema by promoting the excretion of sodium and water through urine. While they are effective in these roles, their long-term use requires careful monitoring, especially in patients with chronic kidney disease (CKD) or those who have recently shown signs of proteinuria.

Proteinuria, the presence of excess protein in urine, can be an indicator of kidney damage or dysfunction. It is essential to understand that while diuretics themselves are not directly nephrotoxic (harmful to the kidneys), their long-term use can lead to complications that may indirectly affect kidney function. For instance, diuretics can cause dehydration and electrolyte imbalances, which can stress the kidneys. In patients with compromised kidney function, these effects can exacerbate existing issues, potentially leading to further deterioration of kidney health.

In your case, having been on diuretics for eight months and now presenting with proteinuria, it is crucial to evaluate the underlying cause of the proteinuria. This could be due to the diuretic use, but it may also be related to other factors such as hypertension, diabetes, or intrinsic kidney disease. Regular follow-up with a nephrologist is advisable to monitor kidney function through blood tests (like serum creatinine and BUN) and urine tests to assess protein levels.

Moreover, it is essential to consider the type of diuretic being used. Loop diuretics (like furosemide) and thiazide diuretics have different profiles and effects on kidney function. Loop diuretics are often used in patients with more severe fluid retention, while thiazides are typically used for hypertension. The choice of diuretic and its dosage should be tailored to the individual’s health status and kidney function.

In addition to monitoring kidney function, lifestyle modifications can also play a significant role in managing kidney health. This includes maintaining a balanced diet, controlling blood pressure, managing blood sugar levels if diabetic, and staying hydrated. Reducing sodium intake can also help minimize fluid retention and the need for diuretics.

In summary, while long-term use of diuretics can be necessary for managing certain medical conditions, it is essential to monitor kidney function closely, especially in patients with signs of proteinuria or pre-existing kidney issues. Regular consultations with a healthcare provider, adherence to prescribed medications, and lifestyle adjustments are vital components of maintaining kidney health. If you have concerns about your current medication regimen or the presence of protein in your urine, please discuss these with your healthcare provider to ensure appropriate management and care.