Association of furosemide versus chlorothiazide exposures with serum sodium, potassium, and chloride among infants with bronchopulmonary dysplasia

J Perinatol. 2025 Mar;45(3):312-318. doi: 10.1038/s41372-024-02159-z. Epub 2024 Nov 5.

Abstract

Objectives: To examine the association of novel furosemide versus thiazide diuretic exposure with changes in serum sodium, potassium, and chloride levels among infants with grade 2/3 bronchopulmonary dysplasia (BPD).

Study design: Retrospective cohort study of infants admitted to a level IV neonatal intensive care unit (NICU) with grade 2/3 BPD. We measured within-subject change in serum sodium, potassium, and chloride before and after diuretic initiation using multivariable regression to adjust for differences in dosing and clinical covariates.

Results: We identified 94 infants contributing 137 novel diuretic exposures. No significant difference was noted in the association between chlorothiazide versus furosemide and serum sodium, potassium, or chloride change in multivariable modeling.

Conclusions: Changes in serum electrolytes were similar for chlorothiazide and furosemide, questioning the perception that chlorothiazide leads to less electrolyte derangement among preterm infants with grade 2/3 BPD.

Publication types

  • Comparative Study

MeSH terms

  • Bronchopulmonary Dysplasia* / blood
  • Bronchopulmonary Dysplasia* / drug therapy
  • Chlorides* / blood
  • Chlorothiazide* / administration & dosage
  • Chlorothiazide* / therapeutic use
  • Diuretics* / therapeutic use
  • Female
  • Furosemide* / administration & dosage
  • Furosemide* / therapeutic use
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Intensive Care Units, Neonatal
  • Male
  • Multivariate Analysis
  • Potassium* / blood
  • Retrospective Studies
  • Sodium* / blood

Substances

  • Furosemide
  • Chlorothiazide
  • Potassium
  • Chlorides
  • Sodium
  • Diuretics