Sites of action of loop diuretics. 1982

E J Cafruny, and H D Itskovitz

Isolated canine kidneys were perfused at a constant systolic pressure of 140 mm Hg with autologous blood. Infusion of maximally effective amounts of furosemide (F) increased the fractional excretion of Cl (FEcl) from 0.03 to 0.18. Parallel changes in FENa and FEH2O were observed and, at maximal response, urine/plasma osmolality was 0.91. Ethacrynic acid (EA) was then added to the infusion fluid and produced a further increase in FECl to 0.28. Urine/plasma osmolality returned to unity. When the order of administration of the two diuretics was reversed, the response to EA alone was greater than after F (from FECl 0.05 control to 0.30 after EA) and the urine became isosmotic (urine/plasma osmolality = 1.0). After F was added, FECl increased further to 0.39. K secretion induced by F or by EA was demonstrable in all experiments. These data indicate that: 1) EA is more effective than F; 2) both drugs can completely inhibit Cl- transport in the thick ascending limb; 3) EA is more effective than F in blocking NaCl transport at sites distal to the loop of Henle; and 4) the proximal tubule is a site of action of F and possibly of EA. Whether the two drugs act entirely on membranal transport systems or, in part, by modifying the production of release of intrarenal substances and/or by diverting blood from one region to another cannot be ascertained from this work.

UI MeSH Term Description Entries
D007444 Inulin A starch found in the tubers and roots of many plants. Since it is hydrolyzable to FRUCTOSE, it is classified as a fructosan. It has been used in physiologic investigation for determination of the rate of glomerular function.
D007684 Kidney Tubules Long convoluted tubules in the nephrons. They collect filtrate from blood passing through the KIDNEY GLOMERULUS and process this filtrate into URINE. Each renal tubule consists of a BOWMAN CAPSULE; PROXIMAL KIDNEY TUBULE; LOOP OF HENLE; DISTAL KIDNEY TUBULE; and KIDNEY COLLECTING DUCT leading to the central cavity of the kidney (KIDNEY PELVIS) that connects to the URETER. Kidney Tubule,Tubule, Kidney,Tubules, Kidney
D008138 Loop of Henle The U-shaped portion of the renal tubule in the KIDNEY MEDULLA, consisting of a descending limb and an ascending limb. It is situated between the PROXIMAL KIDNEY TUBULE and the DISTAL KIDNEY TUBULE. Ascending Limb of Loop of Henle,Descending Limb of Loop of Henle,Henle Loop
D009399 Nephrons The functional units of the kidney, consisting of the glomerulus and the attached tubule. Nephron
D009994 Osmolar Concentration The concentration of osmotically active particles in solution expressed in terms of osmoles of solute per liter of solution. Osmolality is expressed in terms of osmoles of solute per kilogram of solvent. Ionic Strength,Osmolality,Osmolarity,Concentration, Osmolar,Concentrations, Osmolar,Ionic Strengths,Osmolalities,Osmolar Concentrations,Osmolarities,Strength, Ionic,Strengths, Ionic
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D004976 Ethacrynic Acid A compound that inhibits symport of sodium, potassium, and chloride primarily in the ascending limb of Henle, but also in the proximal and distal tubules. This pharmacological action results in excretion of these ions, increased urinary output, and reduction in extracellular fluid. This compound has been classified as a loop or high ceiling diuretic. Edecrin,Etacrynic Acid,Ethacrinic Acid,Ethacrynate Sodium,Ethacrynic Acid, Sodium Salt,Hydromedin,Acid, Etacrynic,Acid, Ethacrinic,Acid, Ethacrynic,Sodium, Ethacrynate
D005665 Furosemide A benzoic-sulfonamide-furan. It is a diuretic with fast onset and short duration that is used for EDEMA and chronic RENAL INSUFFICIENCY. Frusemide,Fursemide,Errolon,Frusemid,Furanthril,Furantral,Furosemide Monohydrochloride,Furosemide Monosodium Salt,Fusid,Lasix
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D001665 Binding Sites The parts of a macromolecule that directly participate in its specific combination with another molecule. Combining Site,Binding Site,Combining Sites,Site, Binding,Site, Combining,Sites, Binding,Sites, Combining

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