MIXED-EFFECTS ANOVA - The urine metabolomic signature of distal diuretics

We assessed the urinary metabolomic fingerprint of treatment with amiloride and hydrochlorothiazide in individuals with CKD stage G3-G4. We identified enhanced ammoniagenesis in the absence of hypokalemia or metabolic acidosis. Patients who developed diuretic-induced hyponatremia exhibited a urinary metabolomic signature of oxidative stress. Our study highlights the interplay between electrolyte and fluid balance and metabolic adaptations in individuals with CKD who are treated with distal diuretics.本研究评估了G3-G4期慢性肾脏病（CKD）患者接受阿米洛利与氢氯噻嗪联合治疗后的尿液代谢组学指纹图谱。研究发现，在未出现低钾血症或代谢性酸中毒的情况下，患者体内氨生成过程显著增强。出现利尿剂诱导低钠血症的患者，其尿液代谢组学特征呈现氧化应激相关变化。本研究揭示了接受远端利尿剂治疗的慢性肾脏病患者体内电解质与体液平衡和代谢适应性之间的相互作用关系。