Q J Med 1995; 88: 49-54
© 1995 Association of Physicians
The role of diuretics in the aetiology of idiopathic oedema
1 Department of Psychiatry, Hairmyres and Stonehouse Hospitals NHS Trust Glasgow 2 Salford Royal Hospitals NHS Trust Manchester 3 Institute of Biochemistry, Glasgow Royal Infirmary Glasgow 4 Stobhill NHS Trust Glasgow, UK
Address correspondence to Dr A.J. Pelosi, Department of Psychiatry, Hairmyres Hospital, East Kilbride, Glasgow G75 8RG
Received 25 May 1994 Accepted for publication 30 August 1994.
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Abstract |
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The hypothesis that diuretic use and abuse and other purging behaviours cause idiopathic oedema was investigated in 102 patients. Of 91 symptomatic idiopathic oedema patients tested at referral, 16 (17.6%) had diuretic and four (4.4%) laxative in their urine. None had grossly disturbed serum urea and electrolytes. Examination of primary care records from 41 idiopathic oedema patients who denied current diuretic consumption, and denied or were uncertain about past consumption, showed that 20 had not been prescribed diuretics by their general practitioners at any time; a further 18 had not been prescribed diuretics for between seven months and 12 years before referral. The absence of evidence of plasma volume depletion (as judged by similar concentrations of mean serum urea, creatinine, total protein and albumin in patient and age-matched control groups) suggests that neither systematic diuretic and laxative use or abuse, nor episodic overeating and vomiting were responsible for symptoms of idiopathic oedema in our patients. Idiopathic oedema has a strong genetic basis, and correction of major and minor risk factors for this condition leads to substantial amelioration of symptoms in most cases.