虽然噻嗪类利尿剂广泛用于治疗原发性高血压已近20年,但对严重肾衰并发高血压病人的疗效尚待评价。因肾衰时随着肾小球滤过率减少,该药的排钠利尿作用将相应降低,当滤过率<20ml/分时,则利尿效应实际丧失。故认为噻嗪利尿剂对进行性肾功不全者极少降压价值。对此亟须临床资料证实。 Although thiazide diuretics are widely used in the treatment of essential hypertension for nearly 20 years, the efficacy of severe renal failure complicated with hypertension remains to be evaluated. Due to renal failure with glomerular filtration rate decreased, the drug’s sodium and diuretic effect will be reduced accordingly, when the filtration rate of <20ml / min, then the actual loss of diuretic effect. Therefore, thiazide diuretics that progressive renal insufficiency few antihypertensive value. This urgent need of clinical data to confirm.