Healthcare professionals traditionally limited the use of diuretics in chronic kidney disease (CKD) due to their possible effects on glomerular filtration rate (GFR) and an increased risk of dialysis.

However, research on the effects of diuretics on kidney health and kidney failure is mixed.

According to a 2023 review of research, some older studies found that taking thiazides, loop diuretics, or a combination of both increased the risk of kidney failure.

However, diuretics are now commonly prescribed to people with CKD to help manage fluid retention and high blood pressure, both of which can increase the risk of kidney failure.

The review authors and other experts also note that these comorbidities may be responsible for kidney failure and other complications, rather than the diuretics specifically.

Diuretics are medications that help your kidneys excrete more water and salt from your body.

Diuretics help increase urine output to excrete excess water and electrolytes in the body. According to the American Kidney Fund, there are three types of diuretics:

  • Loop diuretics: These help reduce excess water, salt, and potassium by affecting the loop of Henle, which is part of the kidney that helps control the volume of urine you produce.
  • Thiazide diuretics: These help balance electrolyte levels by excreting potassium from urine but maintaining calcium in your blood. A doctor may prescribe these if you build a tolerance to loop diuretics.
  • Potassium-sparing: These help flush out fluid and salt from your body while retaining potassium.

Limited research has compared the long-term effects of different types of diuretics on kidney disease progression and kidney failure.

A 2022 study including 47,666 adults with stage 3 or stage 4 CKD looked at the effects of taking thiazide or loop diuretics on CKD progression and the risk of developing end stage renal disease (ESRD), or kidney failure.

Those who took loop diuretics were 10 times more likely to develop kidney failure than people who took no diuretics, while people taking thiazides were only two times more likely.

However, after adjusting for several factors, researchers found no difference between the type of diuretic on the likelihood of developing kidney failure. They also concluded that diuretics did not increase the risk of kidney failure.

Despite recent studies on the link between diuretics and kidney failure, more long-term studies are needed to fully understand how they could affect your kidneys.

A healthcare professional can help develop the best CKD treatment plan for you.