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PubMed1987

SQ 27,786 and SQ 28,853: two angiotensin converting enzyme inhibitors with potent diuretic activity.

SQ 27,786 and SQ 28,853 were designed to possess both angiotensin converting enzyme (ACE) inhibitory and diuretic properties. Both compounds were given to conscious male Sprague-Dawley rats and mongrel female dogs to determine ACE inhibitory and diuretic activities. All animals had previously been equipped with indwelling arterial and venous catheters. Both compounds resulted in dose-related inhibition of an angiotensin I pressor response in rats after i.v. administration. The maximum response and duration of effect of both compounds were similar to that seen with equimolar doses of captopril. Oral doses of SQ 28,853 (50.0 mumol/kg) and SQ 27,786 (15.0 mumol/kg) resulted in 15 and 64% inhibition of ACE, respectively. In conscious normotensive dogs, both compounds (2.0 mg/kg, i.v.) resulted in complete inhibition of ACE. Urine volume was increased by 153 and 667% after SQ 27,786 and SQ 28,853, respectively. Similarly, sodium excretion was increased by 336% after SQ 27,786 and by 650% after SQ 28,853. SQ 27,786 and SQ 28,853 increased potassium excretion by 54 and 115%, respectively. No significant changes in blood pressure were observed with either compound in either species. These results demonstrate that both SQ 27,786 and SQ 28,853 are potent ACE inhibitors and diuretic agents in vivo.

Administration, Oral↗
PubMed2004

Cyclosporine A attenuates the natriuretic action of loop diuretics by inhibition of renal COX-2 expression.

BACKGROUND: It is known that inhibition of cyclooxygenase (COX) impairs the renal actions of loop diuretics. Recently, we found that cyclosporine A (CsA) inhibits renal COX-2 expression. Therefore, we examined the interferences of CsA with the renal actions of loop diuretics. METHOD: We investigated the renal effects of furosemide administration (12 mg/day subcutaneously) in male Sprague-Dawley rats receiving in addition vehicle, CsA (15 mg/kg x day), rofecoxib (10 mg/kg x day), or a combination of both. RESULTS: CsA, rofecoxib, and their combination lowered the furosemide-induced increase of prostaglandin E(2) (PGE(2)) and of 6-keto prostaglandin F(1 alpha) (6-keto PGF(1 alpha)) excretion by 55% and by 70%. They also lowered furosemide stimulated renal excretion of sodium and water by about 65% and 60%. Basal as well as furosemide-induced stimulation of plasma renin activity (PRA) and of renal renin mRNA was further enhanced by CsA. In contrast, rofecoxib attenuated the furosemide-induced rise of PRA and of renin mRNA, both in the absence and in the presence of CsA. In addition, the increase in plasma 6-keto PGF(1 alpha) levels by furosemide was further enhanced by CsA and was attenuated by rofecoxib. CONCLUSION: Taken together, our data suggest that CsA acts as an antinatriuretic, likely by the inhibition of COX-2-mediated renal prostanoid formation. Since the furosemide-induced stimulation of the renin system is not attenuated by CsA but by COX-2 inhibition, we speculate that extrarenal COX-2-derived prostanoids may be involved in the stimulation of the renin system by CsA and by loop diuretics.

6-Ketoprostaglandin F1 alpha↗
PubMed1975

[The mechanism of the diuretic action of chlorazicin].

Diuretic and natriuretic action of chloracizine in rats was not associated with its direct influence on the kidney and was accompanied by increase in the plasma volume, by a fall of the hematocrite index and of the total plasma proteins. A study of endogenous creatinine and of osmotic-free water clearance showed the diuretic action of chloracizine to be mainly due to the increase of glomerular filtration and to reduction of the relative proximal reabsorption.

Animals↗
PubMed1980

Studies on the mechanism and characteristics of action of a uricosuric diuretic, indacrinone (MK-196).

1 The renal action of indacrinone (MK-196), a phenoxyacetic acid derivative with diuretic and uricosuric properties, has been studied in fifteen male subjects. 2 Increasing single doses of up to 60 mg of oral indacrinone produced a linear increase in urinary volume and excretion of Na+ and Cl-, whilst the responses of urinary K+, Ca2+, Mg2+ and uric acid excretion, rose to a plateau at the 40 mg dose. 3 Indacrinone evoked a rapid diuretic response which reached a maximum of 2-4 h and was largely complete at 8-12 h after administration. 4 During maximal hydration, indacrinone produced a substantial fall in fractional free water clearance (CH2O), from 8.89% to 5.83% of the filtered load of water, associated with an increase in osmolal clearance, from 1.38% to 5.78% of the filtered load of solute. The reduction in CH2O was of the same order as that produced by a dose of ethacrynic acid with comparable saluretic activity and significantly greater than that produced by an equi-saluretic dose of hydrochlorothiazide. These findings imply an action of indacrinone upon solute transport in the diluting segments of the distal tubule. 5 At the time of maximal indacrinone-induced saluresis, which amounted to an increase from 0.48% to 4.61% of the filtered load of NaCl, fractional urate clearance increased from 5.16% to 12.24% of the filtered load of uric acid. 6 Indacrinone is a long acting diuretic, sharing some properties in common with both loop diuretics and benzothiadiazines. The results are discussed in relation to structure-activity amongst derivatives of phenoxyacetic acid.

Diuresis↗
PubMed1990

Torasemide, a new loop diuretic, in patients with chronic renal failure.

Torasemide, a new loop diuretic, was administered in 9 hospitalized patients with chronic renal failure to treat both arterial hypertension and peripheral edema. The urine of 5 patients was collected over 12-hour periods to assess the long-lasting diuretic activity of torasemide. Torasemide induced a significant decrease in blood pressure and reversion of peripheral edema in all patients without adverse effects. Torasemide is a high-ceiling loop diuretic, useful in correcting extracellular fluid volume expansion in patients with chronic renal failure.

Adult↗
PubMed2000

Effects of the V(2)-receptor antagonist OPC-41061 and the loop diuretic furosemide alone and in combination in rats.

This study was conducted to characterize the diuretic effect of OPC-41061, a nonpeptide vasopressin V(2)-receptor antagonist, and furosemide by administering each alone and in combination in conscious male rats. OPC-41061 at 1 and 10 mg/kg and furosemide at 10 and 100 mg/kg dose-dependently increased urine volume to the same extent. The high dose of OPC-41061 (10 mg/kg) markedly elevated electrolyte-free water clearance (E-CH(2)o) to a positive value. In contrast to OPC-41061, furosemide elevated only electrolyte clearance but not E-CH(2)o. The differences in diuretic profile reflected the changes in serum sodium and hormone levels. OPC-41061 dose-dependently elevated serum sodium concentration, but furosemide tended to decrease it. The high dose of furosemide (100 mg/kg) significantly elevated serum renin activity and aldosterone concentration, indicating that furosemide activated the renin-angiotensin-aldosterone system (RAA-system). On the other hand, OPC-41061 did not affect these parameters. When OPC-41061 was administered concomitantly with furosemide, OPC-41061 significantly increased urine volume and E-CH(2)o, and decreased urinary osmolality compared with furosemide alone. OPC-41061 dose-dependently elevated serum osmolality and sodium concentration even when administered in combination with the high dose of furosemide. These results suggest that OPC-41061 produces aquaresis leading to increased serum sodium without affecting the RAA-system. On the other hand, furosemide produced natriuresis, leading to decreased serum sodium level and activation of the RAA-system. It was also demonstrated that OPC-41061 produced an additive diuretic effect and elevated serum sodium level in the presence of furosemide.

Aldosterone↗
PubMed2004

Role of nitric oxide pathway in hypotensive and renal effects of furosemide during extracellular volume expansion.

OBJECTIVE: In previous studies we demonstrated that the administration of furosemide associated with L-arginine contributes to enhanced hypotension and induces greater water than electrolyte excretion, in both normal and expansion conditions. The aim of the present study was to elucidate the interaction between furosemide and the nitric oxide (NO) system in renal and vascular responses during extracellular volume expansion. DESIGN AND METHODS: Expanded [10% body weight (bw)] and non-expanded anaesthetized male Wistar rats were treated with furosemide (7.5 mg/kg bw). Mean arterial pressure, nitrite and nitrate excretion (NOx) were determined. NADPH-diaphorase activity, a marker of nitric oxide synthase (NOS) activity, was measured histochemically in different segments of the nephron, aorta and renal arteries. NOS activity was determined using an L-[U14C]-arginine substrate in the kidney and aorta of expanded and non-expanded rats, in basal conditions and after furosemide (10 micromol/l). RESULTS: The hypotensive effect of furosemide was enhanced when NO production was stimulated in expanded and non-expanded animals. The diuretic treatment induced a significant increase in NOx excretion, in NADPH-diaphorase activity in the thick ascending limb of Henle, renal arteries and aorta, and in NOS activity in aorta and kidney in both groups. CONCLUSIONS: Our results suggest that the hypotensive effect of furosemide may be attributed to NO-mediated vasodilation. The enhanced NOS activity, observed in the renal artery of furosemide-treated rats, could explain the increased renal plasma flow induced by furosemide. In addition, NO-pathway stimulation in the kidney could be one of the mechanisms by which furosemide exerts its diuretic and natriuretic effects, in control and in expansion conditions.

Animals↗
PubMedDate not supplied

Heart transplantation in patients with diuretic resistant heart failure.

Advanced heart failure is becoming an increasing cause of mortality and morbidity in a large number of patients. Heart transplantation is the treatment of choice for many selected patients in this group. According to the clinical status at the time of transplant, patients may have a different outcome related to the early survival, while the late results are similar and not affected by the patient's initial clinical status. All surviving patients showed recovery of kidney function as soon the cardiac output was restored to normal values. High urine output was present in a large number of patients in the early postoperative period. However, in severely ill patients with cardiac index <2.5 l/min/m2, diuretic resistance and mortality were higher.

Adolescent↗
PubMed1986

Ethnics differences in the reactions to drugs and xenobiotics. Antihypertensive agents.

Ethnic differences in responsiveness to certain antihypertensive agents have been demonstrated between blacks and whites. Whites exhibit a greater average fall in blood pressure following beta adrenergic blocking drugs and converting enzyme inhibitors than do blacks. On the other hand, the blood pressure of blacks is more responsive to diuretics. While the causes for these ethnic differences are unknown several explanations have been offered. The plasma renin activity of whites tends to be higher than that of blacks. More whites have high or normal plasma renin activity as opposed to blacks who have mostly low renin hypertension. ACE inhibitors and beta blockers may be more effective in whites because these drugs reduce the activity of the renin-angiotensin system. Blacks, on the other hand, are more responsive to diuretics possibly because they have more of a volume dependent hypertension and tend to retain sodium longer than whites.

Antihypertensive Agents↗
PubMed1976

[Comparative evaluation of the effectiveness of diuretics].

The study was conducted in 118 patients with cardiac and pulmonary lesions, aged 18 to 75 years. Among the diuretics the leading role belongs to Uregyt, and Lasix, as judged by their natriuretic and diuretic action, then follow Nuvorit, Hypothiaside and Brinaldix. Renese (polythiaside) produces the same diuretic effect as Nuvorit and Hypothiaside. Renese, Hypothiaside, Lasix and Uregyt enhance kaliuresis and often reduce potassium blood plasma concentrations, while Nuvorit and Brinaldix increase kaliuresis least of all, and often increase the potassium blood plasma level. Within two days of discontinuing Thriamterene nearly all body potassium that was retained under the effect of this drug is excreted. Nuvorit, Hypothiaside, Renese, Brinaldix, Lasix, Uregyt cause similar changes in the acid-base balance (respiratory and metabolic alkalosis), and produce no effect upon the acid-base balance rather seldom. Lasix and Uregyt cause metabolic alkalosis more often than other diuretics. Apart from that, Hypothiaside also causes respiratory acidosis in 1/4 of the patients.

Adolescent↗