
antidiuretic effect of hydrochlorothiazide
in diabetes insipidus
and ch'iuan-lu
12 cases of diabetes insipidus
were studied during hydrochlorothia-
zide therapy under a fixed diet.  the
symptoms, blood pressure, urinary
volume, blood and urinary electrolytes,
plasma volume, electrocardiogram and
hypertonic saline intravenous drip test
were compared before and after treat-
ment.
a daily dose of 100-150 mg
brought down the urinary volume to
about 50% of the pretreatment value.
the initial antidiuretic effect was noted
8 hours after medication and the
maximal effect after the fourth or fifth
day.  owing to the kaluretic action of
the drug, 2-4 gm of potassium salt was
also given each day.  satisfactory re-
sults were obtained with dietary sodium
ion at not more than 200 meq daily, but
ingestion of excessive table salt fre-
quently diminished or even destroyed
the therapeutic effect.
the physical signs, blood pres-
sure and ecg were essentially un-
changed and the plasma volumes were
altered after treatment.  the hyper-
tonic saline test was improved in some
of the patients.
low salt syndrome was fre-
quently encountered as the therapy
continued over 1 month.  but this and
even secondary failure could be pre-
vented by timely use of intermittent or
alternative regimen.
the therapeutic mechanism,
indications and side effects of the drug
were briefly discussed.  the drug might
possibly act through the mechanism of
salt depletion, contraction of extracel-
lular fluid volume and decrease of renal
glomerular filtrate, and in consequence
urinary volume decreases and thirst is
alleviated.
