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Changes in renal operate including acute renal failure could be brought on by drugs that inhibit the renin-angiotensin system and by diuretics. The use of thiazide diuretics has been reported to possibly exacerbate or activate systemic lupus erythematosus. The risk of hypokalemia may be minimized by gradual diuresis, a decrease thiazide dosage, potassium supplementation, or combined use with a potassium-sparing diuretic. Potassium and magnesium depletion may lead to cardiac arrhythmias and cardiac arrest. High levels of potassium may cause weakness, irregular heartbeat, confusion, tingling of the extremities, or feelings of heaviness within the legs. Therapy with AR antagonists ought to be administered cautiously in such patients and in these predisposed to hypovolemic or hyponatremic states (e.g., patients on diuretic therapy, particularly if high doses have been used or if just lately instituted; these on dietary salt restriction; renal dialysis patients). The pharmacokinetics of alfuzosin have not been studied in patients with mild hepatic impairment and warning needs to be exercised if it is administered to such patients.

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