SHORT-TERM EFFECT OF WITHDRAWAL OF DIURETIC DRUGS PRESCRIBED FAR ANKLE EDEMA

Objective-To determine the effect of withdrawing diuretic drugs on oed ema in patients prescribed them for only ankle oedema, excluding patie nts with cardiac, hepatic, or renal failure. Design-Randomised control led trial. Setting-15 general practices in the Netherlands. Patients-1 202 patients aged 65 years or older and taking diuretic drugs, 63 of w hom were eligible for the trial. Main outcome measure-Change in volume trically determined ankle oedema (oedema index) over six weeks. Result s-34 patients were randomised to stop diuretics and 29 to the control group. In eight patients diuretics had to be restarted. Among patients who had diuretics withdrawn successfully, rebound oedema caused a tem porary increase in mean oedema index. The peak level (3.5% (95% confid ence interval 1.5% to 5.2%) was reached in the third week, after which the oedema seemed to be returning to the baseline level. Conclusion-F ew patients who have been prescribed diuretics for only ankle oedema c learly have no contraindications to withdrawing diuretics. If patients are unlikely to have cardiac insufficiency and careful monitoring is provided, withdrawal of diuretics seems to be feasible, though moderat e rebound oedema may occur for a short time.