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DIURETIC-LOOP DIURETICS

Nephrology

DIURETIC-LOOP DIURETICS

1. They remain effective when GFR is low (CrCl < 20 cc/min), but you have to increase the dose and/or give IV.

2. Inhibit the Na+/2CI-/K+ co-transporter & prevent reabsorption of Na+ in the thick ascending segment.

3. Hence, prevents development of the interstitial osmotic gra­dient, relied upon by the thin descending segment for water reabsorption.

4. The net effect is loss of both Na+ and water.

5. K+ is co-transported by the pump that is inhibited by loop diuretics, leading to hypokalemia.

6. Loop diuretics also increase Ca+ loss in the urine.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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