What are elderly patients on Thiazides at risk for?

Elderly patients on thiazide diuretics are at risk for dehydration and kidney stones due to several factors related to the pharmacological action of these medications. Thiazides work by promoting diuresis, which increases urine production and can lead to fluid and electrolyte imbalances. In older adults, whose renal function may already be compromised and whose thirst response may be blunted, this increased diuresis can result in significant fluid loss, leading to dehydration.

Moreover, as thiazides promote the excretion of calcium, this can lead to a higher concentration of calcium in the urine, increasing the risk of calcium-containing kidney stones. Therefore, the combination of diuretic-induced fluid loss and altered calcium metabolism places elderly patients taking thiazides at a particular risk for both dehydration and the formation of kidney stones.

While conditions like heart attack and stroke, gout and arthritis, or anemia and diabetes may also be concerns in elderly patients, they are not directly related to the specific actions of thiazide diuretics in the same way that dehydration and kidney stones are.