Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain
the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in
Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles
and JavaScript.
The US National High Blood Pressure Education Program currently advocates diuretics as first-line treatment for all patients with hypertension, based mainly on the findings of ALLHAT. This Viewpoint identifies several flaws in the design of ALLHAT that call into question the validity of its conclusions. The authors argue that by encouraging use of angiotensin-converting-enzyme inhibitors and calcium channel blockers in ways that are not the standard of care, the trial likely exaggerated the benefits of diuretics in this setting.
Daniel Batlle and colleagues present an approach to the diagnosis and evaluation of hyponatremia that is based on the often-underused concept of electrolyte-free water clearance. Illustrated by a case vignette, this approach is set in the context of emerging evidence supporting the utility of vasopressin receptor antagonists in the management of hyponatremia. The pharmacology, mechanism of action, and efficacy data for drugs of this class are reviewed.
Immunosuppressive drugs, metabolic disorders and immobilization are factors that contribute to an increased incidence of scoliosis, vertebral fractures and back pain in pediatric transplant recipients. Here, a team from Helsinki University Central Hospital review historical data on orthopedic complications in this patient population, and provide updated recommendations for prevention, assessment and management based on their own extensive research and clinical experience.
