Diuretics
,Diuretics
• Carbonic Unhydrase Inhibitors
• Loop Diuretics
• Thiazide Diuretics
• Osmotic Diuretics
• Potassium Sparing Diuretics
2
,Introduction
The kidney:
• filters large quantities of plasma
• reabsorbs substances that the body must conserve, and leaves
behind and/or
• secretes substances that must be eliminated
The two kidneys in humans produce together ~120 mL/min of
ultrafiltrate, yet only 1 mL/min of urine is produced
The basic urine-forming unit of the kidney is the nephron, which
consists of a filtering apparatus
• the glomerulus, connected to a long tubular portion that
reabsorbs and conditions the glomerular ultrafiltrate
3
, The proximal tubule of the nephron is contiguous with Bowman’s
capsule and takes a tortuous path until finally forming a straight
portion that dives into the renal medulla
Normally, ~65% of filtered Na+ is reabsorbed in the proximal tubule
• since this part of the tubule is highly permeable to water, reabsorption is
essentially isotonic
Between the outer and inner strips of the outer medulla, the tubule
abruptly changes morphology to become the descending thin limb
(DTL), which penetrates the inner medulla, makes a hairpin turn,
and then forms the ascending thin limb (ATL)
At the juncture between the inner and outer medulla, the tubule
becomes the thick ascending limb (TAL), which consists of three
segments: a medullary portion (MTAL), a cortical portion (CTAL),
and a postmacular segment
4
,Diuretics
• Carbonic Unhydrase Inhibitors
• Loop Diuretics
• Thiazide Diuretics
• Osmotic Diuretics
• Potassium Sparing Diuretics
2
,Introduction
The kidney:
• filters large quantities of plasma
• reabsorbs substances that the body must conserve, and leaves
behind and/or
• secretes substances that must be eliminated
The two kidneys in humans produce together ~120 mL/min of
ultrafiltrate, yet only 1 mL/min of urine is produced
The basic urine-forming unit of the kidney is the nephron, which
consists of a filtering apparatus
• the glomerulus, connected to a long tubular portion that
reabsorbs and conditions the glomerular ultrafiltrate
3
, The proximal tubule of the nephron is contiguous with Bowman’s
capsule and takes a tortuous path until finally forming a straight
portion that dives into the renal medulla
Normally, ~65% of filtered Na+ is reabsorbed in the proximal tubule
• since this part of the tubule is highly permeable to water, reabsorption is
essentially isotonic
Between the outer and inner strips of the outer medulla, the tubule
abruptly changes morphology to become the descending thin limb
(DTL), which penetrates the inner medulla, makes a hairpin turn,
and then forms the ascending thin limb (ATL)
At the juncture between the inner and outer medulla, the tubule
becomes the thick ascending limb (TAL), which consists of three
segments: a medullary portion (MTAL), a cortical portion (CTAL),
and a postmacular segment
4
