Abstract
            Introduction: Hypertension is a significant risk factor for cardiovascular disease (CVD),  including coronary artery disease, cerebrovascular disease, peripheral artery disease, and  arteriosclerosis. Hypertension also increases serum creatinine, which is a marker of renal  dysfunction. Chlorthalidone (CTDN) is an effective agent for lowering blood pressure in patients  with essential hypertension. However, studies have reported adverse events in specific patients,  particularly those with cardiovascular and renal diseases. This study aims to evaluate the effects  of CTDN on cardiovascular and renal diseases.  
  Methods: This study was conducted according to the PRISMA-P guidelines 2015. We  systematically searched the PubMed database for keywords related to CTDN, clinical trials,  renal dialysis, and hemodialysis. Two independent reviewers selected the studies and extracted  the data.  
  Results: There were 22 articles included in this study: 17 articles about CTDN and CVDs, and 5  articles about CTDN and renal diseases. This study showed variable results among the published  articles. CTDN seems to have a good effect in preventing CVDs, cardiac remodeling, and  decreasing blood pressure. However, physicians should consider the potential adverse events  that may occur, including hypokalemia, hyponatremia, hyperuricemia, and an increase in serum  creatinine levels.  
  Conclusion: CTDN has a beneficial effect on CVDs. Nonetheless, the use of CTDN in renal  diseases should be monitored due to potential adverse events. CTDN may considered  inappropriate in cases of severely decreased renal function. Therefore, we recommend that  CTDN can be used in patients with hypertension without renal comorbidities.