[Potential dangers of diuretics...].

A chronic diuretic abuse is common among healthy young women. An acute cessation of diuretic intake causes renal sodium retention with formation of edema due to diuretic-induced secondary hyperaldosteronism. Therefore, diuretics should be tappered over weeks or even months in these patients. Other clinical situations where therapy with diuretics is potentially deleterious are pregnancy and systemic sclerosis. In pregnant women, diuretic-induced acute or chronic depletion of the plasma volume can lead to placental hypoperfusion and preeclampsia. Patients with systemic sclerosis have very high levels of blood renin. Diuretic-induced volume depletion provides another stimulus of the renin-angiotensin system and may cause a rapidly progressive renal failure requiring dialysis within days or weeks. The sclerodermal renal crisis is associated with a high early mortality. There is evidence that sclerodermal renal crisis can be avoided when patients are treated with an Angiotensin Converting Enzyme (ACE) inhibitor.