Effectiveness and safety of chronic diuretic use in older adults: an umbrella review of recently published systematic reviews and meta-analyses of randomized-controlled trials

Van Poelgeest E., Prokopidis K., Erdogan T., Kwak M. J., Piotrowicz K., Paoletti L., ...More

European Geriatric Medicine, vol.16, no.4, pp.1353-1387, 2025 (SCI-Expanded, Scopus) identifier identifier identifier

  • Publication Type: Article / Review
  • Volume: 16 Issue: 4
  • Publication Date: 2025
  • Doi Number: 10.1007/s41999-025-01229-5
  • Journal Name: European Geriatric Medicine
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
  • Page Numbers: pp.1353-1387
  • Keywords: Adverse outcome, Benefit, Diuretics, Efficacy, Meta-analysis, Umbrella review
  • Istanbul University Affiliated: Yes

Abstract

Aim: This umbrella review aimed to summarize the literature on the efficacy and safety of chronic diuretic treatment in adults. Findings: Certain diuretics or diuretic subclasses offer significant benefits for key clinical outcomes, such as reducing cardiovascular mortality and heart failure-related hospitalizations. However, chronic diuretic use carries potential risks, including an increased risk of hyperkalemia, with age-related differences in adverse event risks [older adults (≥ 65 years) facing higher risks, while younger populations do not show similar concerns]. Message: Further research is needed to establish diuretic efficacy and safety in populations commonly seen in clinical practice, especially older adults living with multimorbidity and frailty.