What is a potential side effect of diuretics in neonates?

The potential side effect of diuretics in neonates that is often highlighted is hypokalemia. Diuretics work by promoting the excretion of sodium and water from the body, which can lead to an imbalance in electrolytes. Specifically, many diuretics, especially loop and thiazide diuretics, can cause the kidneys to excrete not only excess fluid but also potassium, which is essential for various bodily functions, including maintaining normal heart rhythm and muscle function.

In neonates, who are particularly vulnerable to electrolyte imbalances due to their smaller body size and differing physiology, hypokalemia can pose significant clinical risks. Symptoms of low potassium can include muscle weakness, respiratory distress, and cardiac arrhythmias, making monitoring and management of potassium levels critical when diuretics are used.

While other side effects of diuretics might be relevant in different contexts, such as fluid retention potentially occurring in some cases of heart failure or hypertension as a result of fluid shifts, it is the risk of hypokalemia that is particularly associated with diuretic therapy in this population. This risk underscores the importance of careful electrolyte monitoring in neonates receiving diuretic treatment.