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(New page: {{subpages}} '''Diuretics''' are "agents that promote the excretion of urine through their effects on kidney function."<ref>{{MeSH}}</ref> Symporters: Membrane transporters that...)
 
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'''Diuretics''' are "agents that promote the excretion of [[urine]] through their effects on [[kidney]] function."<ref>{{MeSH}}</ref>
'''Diuretics''' are "agents that promote the excretion of [[urine]] through their effects on [[kidney]] function."<ref>{{MeSH}}</ref>


Symporters:
==Physiology of sodium reabsorption in the kidney==
 
 
Membrane transporters that co-transport two or more dissimilar molecules in the same direction across a membrane. Usually the transport of one ion or molecule  is against its electrochemical gradient and is "powered" by the movement of  another ion or molecule with its electrochemical gradient.




{| class="wikitable"
|+ Physiology of sodium reabsorption in the kidney
! Location in nephron !! Proportion of total sodium reabsorption<br>accounted for!! [[Ion pump]]!! heading
|-
| Proximal convulated tubule || 40% || [[sodium-hydrogen antiporter]] || Carbonic anhydrase inhibitors
|-
| Late proximal tubule || &nbsp; || [[chloride-bicarbonate antiporter]] || cell
|-
| Loop of Henle:<br>thin descending limb  || 0% || Not applicable || Osmotic diuretics
|-
| Loop of Henle:<br>thick ascending limb<br>('diluting segment') || 25% || [[sodium potassium chloride symporter]] || Loop diuretics
|-
| Distal convulated tubule || 10% || [[Sodium chloride symporter]] || Thiazides
|-
| Collecting tubule || 2-5% || &nbsp; || cell
|}


==Classification==
===Carbonic anhydrase inhibitors===
Carbonic anhydrase inhibitors are a "class of compounds that reduces the secretion of h+ ions by the proximal kidney tubule through inhibition of carbonic anhydrases."<ref>{{MeSH|Carbonic anhydrase inhibitors}}</ref><ref name="isbn0-8385-0598-8p483p249">{{cite book |author=Katzung, Bertram G. |title=Basic & Clinical Pharmacology |chapter=Diuretic Agents|publisher=Lange Medical Books/McGraw-Hill |location=New York |year=2001 |pages=249 |isbn=0-8385-0598-8 |oclc= |doi=}}</ref>


Proximal tubule
* proximal convulated tubule 40% of NaCl reabsorption uses the [['''sodium-hydrogen antiporter''']] (exchanger)
* late proximal tubule uses the [[chloride-bicarbonate antiporter]] (exchanger)
Loop of Henle
* thin descending limb reabsorbs water rather than sodium
* thick ascending limb Henle (also called the diluting segment) uses the [[sodium potassium chloride symporter]] 25%
distal convulated tubule 10% of NaCl reabsorption
collecting tubule 2-5% of NaCl reabsorption
==Classification==
===Osmotic diuretic===
===Osmotic diuretic===
Osmotic diuretics  are "compounds that increase urine volume by increasing the amount of osmotically  active solute in the urine. Osmotic diuretics also increase the osmolarity of  plasma."<ref>{{MeSH|Osmotic diuretics}}</ref>
Osmotic diuretics  are "compounds that increase urine volume by increasing the amount of osmotically  active solute in the urine. Osmotic diuretics also increase the osmolarity of  plasma."<ref>{{MeSH|Osmotic diuretics}}</ref>


===Sodium potassium chloride symporter inhibitors===
===Loop diuretics===
Also called loop diuretics, these are agents that inhibit sodium-potassium-chloride symporters which are concentrated in the thick ascending limb at the junction of the [[Loop of Henle]] and distal kidney tubules. They act as diuretics. Excess use is associated with hypokalemia and hyperglycemia.<ref>{{MeSH|Sodium Potassium Chloride Symporter Inhibitors}}</ref>
More formally called sodium potassium chloride symporter inhibitors, these are agents that inhibit sodium-potassium-chloride symporters in the thick ascending limb at the junction of the [[Loop of Henle]] and distal kidney tubules.<ref>{{MeSH|Sodium Potassium Chloride Symporter Inhibitors}}</ref>


===Thiazides===
===Thiazides===
Thiazides are "heterocyclic compounds with sulfur and nitrogen in the ring. this term commonly refers to the benzothiadiazines that inhibit sodium-potassium-chloride symporters and are used as diuretics."<ref>{{MeSH|Thiazides}}</ref>
Thiazides are "heterocyclic compounds with sulfur and nitrogen in the ring. This term commonly refers to the benzothiadiazines that inhibit sodium-potassium-chloride symporters."<ref>{{MeSH|Thiazides}}</ref>


===Potassium-sparing diuretics===
===Potassium-sparing diuretics===
 
These work in the dital convoluted tubule and the collecting duct.
 
===Carbonic anhydrase inhibitors===
<ref name="isbn0-8385-0598-8p483p249">{{cite book |author=Katzung, Bertram G. |title=Basic & Clinical Pharmacology |chapter=Diuretic Agents|publisher=Lange Medical Books/McGraw-Hill |location=New York |year=2001 |pages=249 |isbn=0-8385-0598-8 |oclc= |doi=}}</ref>
 


==References==
==References==
<references/>
<references/>

Revision as of 22:25, 18 June 2008

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Diuretics are "agents that promote the excretion of urine through their effects on kidney function."[1]

Physiology of sodium reabsorption in the kidney

Physiology of sodium reabsorption in the kidney
Location in nephron Proportion of total sodium reabsorption
accounted for		 Ion pump heading
Proximal convulated tubule 40% sodium-hydrogen antiporter Carbonic anhydrase inhibitors
Late proximal tubule   chloride-bicarbonate antiporter cell
Loop of Henle:
thin descending limb		 0% Not applicable Osmotic diuretics
Loop of Henle:
thick ascending limb
('diluting segment')		 25% sodium potassium chloride symporter Loop diuretics
Distal convulated tubule 10% Sodium chloride symporter Thiazides
Collecting tubule 2-5%   cell

Classification

Carbonic anhydrase inhibitors

Carbonic anhydrase inhibitors are a "class of compounds that reduces the secretion of h+ ions by the proximal kidney tubule through inhibition of carbonic anhydrases."[2][3]

Osmotic diuretic

Osmotic diuretics are "compounds that increase urine volume by increasing the amount of osmotically active solute in the urine. Osmotic diuretics also increase the osmolarity of plasma."[4]

Loop diuretics

More formally called sodium potassium chloride symporter inhibitors, these are agents that inhibit sodium-potassium-chloride symporters in the thick ascending limb at the junction of the Loop of Henle and distal kidney tubules.[5]

Thiazides

Thiazides are "heterocyclic compounds with sulfur and nitrogen in the ring. This term commonly refers to the benzothiadiazines that inhibit sodium-potassium-chloride symporters."[6]

Potassium-sparing diuretics

These work in the dital convoluted tubule and the collecting duct.

References

  1. ↑ Anonymous (2024), Diuretic (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ Anonymous (2024), Carbonic anhydrase inhibitors (English). Medical Subject Headings. U.S. National Library of Medicine.
  3. ↑ Katzung, Bertram G. (2001). “Diuretic Agents”, Basic & Clinical Pharmacology. New York: Lange Medical Books/McGraw-Hill, 249. ISBN 0-8385-0598-8. 
  4. ↑ Anonymous (2024), Osmotic diuretics (English). Medical Subject Headings. U.S. National Library of Medicine.
  5. ↑ Anonymous (2024), Sodium Potassium Chloride Symporter Inhibitors (English). Medical Subject Headings. U.S. National Library of Medicine.
  6. ↑ Anonymous (2024), Thiazides (English). Medical Subject Headings. U.S. National Library of Medicine.
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