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

Eveline van Poelgeest; Konstantinos Prokopidis; Tuğba Erdogan; Min Ji Kwak; Karolina Piotrowicz; Luca Paoletti; Annette Eidam; Fatma Özge Kayhan Koçak; Birkan Ilhan; Alessia Beccacece; George Soulis; Serdar Özkök; Gulistan Bahat; Eva Topinková; Joost Daams; M Louis Handoko; Parag Goyal; Jerzy Gąsowski; Antonio Cherubini; Nicola Veronese; Giuseppe Dario Testa; Wade Thompson; Nathalie van der Velde

doi:10.1007/s41999-025-01229-5

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

Eveline van Poelgeest^*
, Konstantinos Prokopidis
, Tuğba Erdogan
, Min Ji Kwak
, Karolina Piotrowicz
, Luca Paoletti
, Annette Eidam
, Fatma Özge Kayhan Koçak
, Birkan Ilhan
, Alessia Beccacece
, George Soulis
, Serdar Özkök
, Gulistan Bahat
, Eva Topinková
, Joost Daams
, M Louis Handoko
, Parag Goyal
, Jerzy Gąsowski
, Antonio Cherubini
, Nicola Veronese

Giuseppe Dario Testa, Wade Thompson, Nathalie van der Velde,

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

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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.

Original language	English
Pages (from-to)	1353-1387
Number of pages	35
Journal	European Geriatric Medicine
Volume	16
Issue number	4
Early online date	25 May 2025
DOIs	https://doi.org/10.1007/s41999-025-01229-5
Publication status	Published - Aug 2025

Keywords

Adverse outcome
Benefit
Diuretics
Efficacy
Meta-analysis
Umbrella review

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10.1007/s41999-025-01229-5Licence: CC BY

Effectiveness and safety of chronic diuretic use in older adults: an umbrella review of recently published systematic reviews and meta-analyses of randomized-controlled trialsFinal published version, 1.32 MBLicence: CC BY

Cite this

van Poelgeest, E., Prokopidis, K., Erdogan, T., Kwak, M. J., Piotrowicz, K., Paoletti, L., Eidam, A., Koçak, F. Ö. K., Ilhan, B., Beccacece, A., Soulis, G., Özkök, S., Bahat, G., Topinková, E., Daams, J., Handoko, M. L., Goyal, P., Gąsowski, J., Cherubini, A. (2025). 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. European Geriatric Medicine, 16(4), 1353-1387. https://doi.org/10.1007/s41999-025-01229-5

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title = "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",

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.",

keywords = "Adverse outcome, Benefit, Diuretics, Efficacy, Meta-analysis, Umbrella review",

author = "\{van Poelgeest\}, Eveline and Konstantinos Prokopidis and Tuğba Erdogan and Kwak, \{Min Ji\} and Karolina Piotrowicz and Luca Paoletti and Annette Eidam and Ko{\c c}ak, \{Fatma {\"O}zge Kayhan\} and Birkan Ilhan and Alessia Beccacece and George Soulis and Serdar {\"O}zk{\"o}k and Gulistan Bahat and Eva Topinkov{\'a} and Joost Daams and Handoko, \{M Louis\} and Parag Goyal and Jerzy G{\c a}sowski and Antonio Cherubini and Nicola Veronese and Testa, \{Giuseppe Dario\} and Wade Thompson and \{van der Velde\}, Nathalie",

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year = "2025",

month = aug,

doi = "10.1007/s41999-025-01229-5",

language = "English",

volume = "16",

pages = "1353--1387",

journal = "European Geriatric Medicine",

issn = "1878-7649",

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van Poelgeest, E, Prokopidis, K, Erdogan, T, Kwak, MJ, Piotrowicz, K, Paoletti, L, Eidam, A, Koçak, FÖK, Ilhan, B, Beccacece, A, Soulis, G, Özkök, S, Bahat, G, Topinková, E, Daams, J, Handoko, ML, Goyal, P, Gąsowski, J, Cherubini, A, Veronese, N, Testa, GD, Thompson, W, van der Velde, N 2025, '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', European Geriatric Medicine, vol. 16, no. 4, pp. 1353-1387. https://doi.org/10.1007/s41999-025-01229-5

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, Eveline; Prokopidis, Konstantinos; Erdogan, Tuğba et al.
In: European Geriatric Medicine, Vol. 16, No. 4, 08.2025, p. 1353-1387.

Research output: Contribution to journal › Review article › peer-review

TY - JOUR

T1 - Effectiveness and safety of chronic diuretic use in older adults

T2 - an umbrella review of recently published systematic reviews and meta-analyses of randomized-controlled trials

AU - van Poelgeest, Eveline

AU - Prokopidis, Konstantinos

AU - Erdogan, Tuğba

AU - Kwak, Min Ji

AU - Piotrowicz, Karolina

AU - Paoletti, Luca

AU - Eidam, Annette

AU - Koçak, Fatma Özge Kayhan

AU - Ilhan, Birkan

AU - Beccacece, Alessia

AU - Soulis, George

AU - Özkök, Serdar

AU - Bahat, Gulistan

AU - Topinková, Eva

AU - Daams, Joost

AU - Handoko, M Louis

AU - Goyal, Parag

AU - Gąsowski, Jerzy

AU - Cherubini, Antonio

AU - Veronese, Nicola

AU - Testa, Giuseppe Dario

AU - Thompson, Wade

AU - van der Velde, Nathalie

PY - 2025/8

Y1 - 2025/8

N2 - 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.

AB - 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.

KW - Adverse outcome

KW - Benefit

KW - Diuretics

KW - Efficacy

KW - Meta-analysis

KW - Umbrella review

UR - https://www.scopus.com/pages/publications/105006576244

U2 - 10.1007/s41999-025-01229-5

DO - 10.1007/s41999-025-01229-5

M3 - Review article

C2 - 40413712

SN - 1878-7649

VL - 16

SP - 1353

EP - 1387

JO - European Geriatric Medicine

JF - European Geriatric Medicine

IS - 4

ER -

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

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Keywords

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