Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “DIURETICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,405 records · Page 78Linked to original sources
PubMed1983

The chronic compartment syndrome and response to diuretic treatment.

In five middle-aged men with calf pain during jogging or fast walking, chronic compartment syndrome of the calf or anterior tibial muscles was revealed by circulatory studies which included measurement of compartment tissue pressure. After two to three weeks of diuretic medication the men were re-examined. Initially elevated compartment tissue pressures at rest and after exercise were significantly decreased following diuretic treatment. The study indicates that calf pain similar to that of arterial insufficiency may be caused by compartment syndrome even in elderly persons and may be relieved with diuretic medication.

Adult↗
PubMed1978

[Inappropriate secretion of anti-diuretic hormone in a case of intermittent acute porphyria (author's transl)].

The authors report the case of a patient who presented, during two exacerbations of intermittent acute porphyria, a grave psychiatric syndrome secondary to severe hyponatraemia. The later was due to inappropriate secretion of anti-diuretic hormone confirmed by laboratory tests and the stimation of anti-diuretic activity in the urine. The course was favourable under the effects of symptomatic treatment including sodium supplements and fluid restriction. The anti-diuretic syndrome disappeared on each occasion without sequelae at the time of regression of the exacerbation of porphyria.

Acute Disease↗
PubMed1978

The influence of indomethacin on the pharmacokinetics, diuretic response and hemodynamics of furosemide in the dog.

Indomethacin has the potential to interact with furosemide in a number of different fashions. We have investigated some of these possibilities in seven mongrel dogs that received furosemide (2 mg/kg i.v.). Plasma and urinary concentration of furosemide were measured by high performance liquid chromatography, diuretic response was assessed by urinary sodium excretion and renal blood flow and its distribution were estimated using the radioactive microsphere technique. Furosemide induced a prompt diuresis associated with a 50% increase in total renal blood flow. Intrarenal blood flow was preferentially increased in the inner cortical zones. Furosemide was rapidly eliminated with a renal clearance that was 35% of the total systemic clearance. Maximal sodium excretion was attained at plasma furosemide concentrations greater than 0.8 microgram/ml; below this concentration there was a linear relationship between plasma concentration and rate of sodium excretion. The ratio of sodium/furosemide concentration in urine rose to a plateau, then remained constant. Indomethacin pretreatment inhibited the hemodynamic response to furosemide. In addition, indomethacin reduced the renal and extrarenal clearance of furosemide by approximately 30%, but did not change the proportion of unchanged drug excreted in the urine. Although the diuretic response for any given plasma concentration of furosemide was reduced, the ratio of urinary sodium/furosemide concentration was not changed by indomethacin. Since the amount of furosemide reaching the urine was not altered, the total diuretic response was not significantly affected by indomethacin. From these observations we conclude that indomethacin alters the pharmacokinetics of the disposition of furosemide and furosemide-induced renal hemodynamic changes. However, our data indicate that the response of the renal tubule to furosemide secreted into tubular fluid is not changed by indomethacin.

Animals↗
PubMed1982

Nonrenal clearance of furosemide as a cause of diuretic response variability in the rat.

In clinical practice, the patient-to-patient variability in furosemide response is a well known fact. To study whether changes in furosemide metabolism may contribute to this variability, 72 rats received furosemide in a dose of 5 mg/kg i.p. There was a good correlation between the percentage of furosemide recovered in the urine and the diuretic effect. Accordingly, the rats were separated into groups corresponding to good responders (GR) and poor responders (PR) based on the extent of diuresis and the percentage of furosemide recovered in the urine. In an in vivo experiment, 12 rats received 30 mg/kg of chloramphenicol i.p. 30 min before furosemide. In PR rats, the average percentage of furosemide (+/- S.D.) in urine increased from 24.1 +/- 6.3 to 67.1 +/- 8.9 (P less than .001) and urine volume increased from 13.5 +/- 4.6 to 28.6 +/- 3.5 ml/24 hr (P less than .005). No such changes were observed in the group of GR rats. In a subsequent experiment, 11 GR rats received 80 mg/Kg of phenobarbital i.p. for 5 days before furosemide. The percentage of furosemide recovered in the urine decreased significantly (53.4 +/- 10.2 to 39.8 +/- 7.2, P less than .01), although the diuretic effect was not modified. In vitro studies confirmed that the T 1/2 of furosemide biotransformation in liver was different in GR and PR rats: 63.6 +/- 5.5 vs. 43.5 +2- 2.8 min, respectively (P less than .001). After receiving chloramphenicol, PR rats showed a longer T 1/2 of biotransformation in liver of 54.8 +/- 6.4 min (p less than .05 when compared to PR controls). After the administration of phenobarbital, GR rats showed a short T 1/2 of 35.3 +/- 7.0 min (P less than .005 when compared to GR controls). It is concluded that in the rat, the variability in diuretic responses to furosemide is related to the capacity of the individual rat to metabolize furosemide and that furosemide metabolism may be inhibited by chloramphenicol and increased by phenobarbital.

Animals↗
PubMed1980

Hypokalemia during the treatment of arterial hypertension with diuretics.

In a study of 50 patients with uncomplicated arterial hypertension the administration of hydrochlorothiazide, 50 to 100 mg daily or every other day, with or without reserpine, 0.25 mg daily, resulted in a fall in the mean blood pressure from 182/113 to 144/92 mm Hg. The mean duration of therapy was 19 months. The mean serum potassium concentration was 4.3 mmol/l before the onset of therapy. It fell during the first 6 weeks of treatment, but seldom below 3.5 mmol/l, then rose gradually and spontaneously to 4.1 mmol/l after 19 months of therapy. All the patients remained asymptomatic. These findings bring into question the routine use of potassium supplements or a potassium-sparing diuretic, such as spironolactone or triamterene, during the treatment of hypertension with diuretics such as the thiazides. The use of potassium supplements or a potassium-sparing agent may induce hyperkalemia in spite of the simultaneous administration of a diuretic that acts more proximally. Since hyperkalemia is potentially lethal, the serum potassium concentration should be carefully monitored in any patient receiving potassium supplements or a potassium-sparing agent.

Adult↗
PubMed1995

Inhaled loop diuretics and basal airway responsiveness in man: evidence of a role for cyclo-oxygenase products.

Inhaled frusemide protects asthmatic airways against a wide variety of bronchoconstrictor stimuli by unknown mechanisms. To investigate whether inhaled loop diuretics modulate baseline bronchial responsiveness, a randomized, double-blind, placebo-controlled study was conducted to test the ability of frusemide (40 mg) and bumetanide (2 mg) to displace concentration-response curves with methacholine in 14 healthy volunteers. In addition, separate randomized, double-blind studies were carried out to evaluate the effects of oral flurbiprofen, a potent cyclo-oxygenase inhibitor, on the protective action of frusemide against methacholine-induced bronchoconstriction. Inhaled loop diuretics significantly increased the provocative concentration of methacholine causing a 15% decrease in forced expiratory volume in one second (PC15FEV1) from the geometric mean (range) value of 58.6 (9.2-233) mg.ml-1 after placebo administration, to 129 (13.8-505) and to 106 (6.6-510) mg.ml-1 after administration of frusemide and bumetanide, respectively. Similar results were obtained when data from partial flow-volume curves were used for analysis. In the eight subjects studied, pretreatment with oral placebo and inhaled frusemide reduced airway responsiveness to methacholine, with a geometric mean (range) PC15FEV1 value of 116 (25.4-405) mg.ml-1, and premedication with oral flurbiprofen abolished this protective effect, the geometric mean (range) PC15FEV1 methacholine being reduced to a value of 50.3 (16.6-189) mg.ml-1. In addition, oral flurbiprofen alone failed to alter airway responsiveness to methacholine. In view of these findings, it is suggested that bronchoprotective prostaglandins may mediate the effects of loop diuretics against methacholine-induced bronchoconstriction in man.

Administration, Inhalation↗
PubMed1994

Urapidil compared with diuretics in the treatment of mild-to-moderate essential hypertensive patients: effects on glucose metabolism, insulin sensitivity, and lipid profile.

In this study, 14 mild-to-moderate essential hypertensive patients of both sexes were studied with regard to the effects of two different treatments, urapidil (60 to 180 mg/day) and diuretics (chlorthalidone and hydrochlorothiazide-25 to 50 mg/day) on glucose metabolism, insulin sensitivity and plasma lipid profile. Blood pressure was equally reduced by both treatments. However, urapidil treatment was accompanied by significant lower plasma levels of cholesterol, HDL-cholesterol and triglycerides as compared with diuretic treatment. Also, a significantly higher insulin sensitivity index, determined by the euglycemic insulin clamp technique, was observed during urapidil therapy. Our results demonstrated that urapidil is as effective as diuretics in reducing blood pressure of essential hypertensive patients, with the potential advantage of a favorable profile in regard to the glucose and lipid metabolisms.

Adult↗
PubMed1976

Diuretic and clinical effects of low-dose furosemide in congestive heart failure patients.

A dose of 20 mg furosemide in congestive heart failure patients produces a significant diuretic and natriuretic effect. The peak effect was observed within 60-120 minutes in most patients. Twenty-four congestive heart failure patients were hospitalized for evaluation and management. Two withdrew from the study, and in three there was a prolonged (several months) remission of manifestations of congestive heart failure. The remaining 19 patients were treated with 40 mg furosemide per day for a four-week period. Six required 80 to 120 mg furosemide per day, and 13 were controlled on 40 mg per day. On 20 mg twice per day, one of the 13 patients dropped out voluntarily, two required a higher dose of furosemide, and 10 were controlled on this regimen for a four-week period. When dosage was reduced to 20 mg per day, five of the ten patients were controlled for an additional four weeks or longer, and five required higher doses of furosemide. Results of this study suggest that in congestive heart failure patients, 20 mg furosemide per day has significant diuretic and natriuretic properties. It also demonstrates that a number of patients with cardiac decompensation can be controlled on a relatively low dosage of furosemide and that periodic reevaluation of clinical status and diuretic requirements for maintenance therapy is of critical importance in management of patients with congestive heart failure.

Adult↗
PubMed1994

[Relationship of the renin-angiotensin-aldosterone system with auricular natriuretic factor in its response to the action of thiazide diuretics and to nifedipine, a sustained-release calcium antagonist].

BACKGROUND: Blood pressure (BP) response to diuretics may be considered as an index of salt-sensitivity. Salt-sensitive patients may have an enhanced response to calcium channel blockers. In this study we correlate the basal values of two of the hormonal systems involved in the control of Na balance comparing them with the antihypertensive effects of a calcium channel blocker and a diuretic, to assess if BP response depends of a particular hormonal pattern by which we could define salt-sensitive patients. METHODS: We studied 21 essential hypertensive patients in a lineal sequence in an open protocol, first treated with slow release nifedipine (Nif-30), 30 mg daily, as a single dose, for 30 days, followed by amiloride+hydrochlorothiazide (HCT+Am), 50 mg and 5 mg, daily, for another month. Plasma renin activity (PRA), plasma aldosterone (PAld) and 24 hours urinary aldosterone (UAld) and atrial natriuretic factor (ANF), were measured at the start and end of the study. The hormonal values on each group were compared and correlated with changes observed in BP at the end of each period of treatment. RESULTS: HCT+Am decreased median arterial pressure (MAP) from 121.4 +/- 11 to 110.4 +/- 8 mmHg and Nif-30 to 108.7 +/- 12.4 mmHg, both p < 0.0004. There were 76% controlling MAP with Nif-30 whereas 48% did so with HCT+Am, p < 0.01, HCT+Am also increased PRA, PAld and decreased ANF, Ca urinary excretion and plasma PTH. Nif-30 did not alter the renin-angiotensin-aldosterone system, nor ANF. PTH remained unchanged. The MAP decrement caused by HCT+Am depended on baseline BP, r = -0.69, p < 0.0005, whereas Nif-30 decreased MAP independent from its baseline values, r = -0.02, NS. PAld showed a reverse correlation with ANF after treatment, r = -0.43, p < 0.05. The decrease of MAP holds a reverse relationship with ANF, both with HCT+Am, r = -0.47, p < 0.02, and with Nif-30, r = -0.45, p < 0.04. CONCLUSIONS: Treatment with Nif-30 was superior to HCT+Am in number of patients controlled, but the decrease in MAP is similar. Since the antihypertensive response to diuretic therapy and to calcium channel-blockers is related to low levels of ANF this fact could indicate some sort of defect of ANF secretion.

Aldosterone↗
PubMed1994

Alteration of renal receptors for atrial natriuretic peptide and vasopressin in spontaneously hypertensive rats treated with antihypertensive diuretics.

To investigate the alteration of the renal atrial natriuretic peptide (ANP) and arginine vasopressin (AVP) receptors in the controlled hypertensive state of spontaneously hypertensive rat (SHR) treated with antihypertensive diuretics, 12 weeks old SHRs were administered an antihypertensive diuretic, furosemide, trichloromethiazide, or indapamide, daily for 10 days and investigated by radiolabeled receptor assay (RRA) of ANP and AVP. The urine volume was significantly increased in all groups treated with antihypertensive diuretics as compared with the untreated control group on day 3. Systolic blood pressure was significantly decreased in groups treated with both trichloromethiazide and indapamide. The number of renal ANP receptors decreased; affinity was increased only in the SHR administered indapamide. The affinity of the renal AVP receptor was also decreased in that group. Alteration of ANP and AVP receptors was observed only in the group treated with indapamide. This indicates that the ANP and AVP receptor in the kidney of SHR was changed not only by diuresis or reduction of blood pressure, but by the pharmacological action of indapamide.

Animals↗
PubMed1993

[Comparison of the clinical effect between digoxin and a diuretic in chronic left heart failure and sinus rhythm].

Because of conflicting results from studies examining the initial treatment of patients with chronic left heart failure (CHF) and sinus rhythm, the clinical efficacy and safety of digoxin and a diuretic were compared in a multicenter, randomised, open twelve-week study. 47 patients with CHF (NYHA II and III) were treated either with digoxin or a combination of hydrochlorothiazide and triamterene. Three patients from the diuretic group and four from the digoxin group required premature termination of study periods because of increasing symptoms of CHF. Both regimens decreased significantly a heart failure score and increased distinctly the symptom-limited exercise tolerance, but results did not differ between the groups. Echocardiographic parameters, ejection fraction and radionuclide indices of diastolic function estimated by gated blood pool scan did not change with either treatment. It was concluded that digoxin or the diuretic therapy alone was effective in ameliorating the clinical signs of CHF. Due to missing differences in the clinical efficacy of both drugs an individual and not schematic treatment regimen of CHF is warranted.

Aged↗
PubMed1993

Normalized clearance-to-uptake slope ratio: a method to minimize false-positive diuretic renograms.

The success of diuretic renography in the evaluation of children with renal outflow tract obstruction has been hampered by a high incidence of false-positive and indeterminate results. The main causes of interpretative errors are collecting system dilatation and impaired renal function. In this prospective study, we introduce a parameter with the potential to overcome these two problems: the normalized slope ratio (SRn). This ratio is calculated from the division of the maximum renal clearance slope by the maximum renal uptake slope, both normalized to peak renal activity. Fifty-one children (94 renal units) were evaluated. Traditional parameters such as diuretic half-time and percentage of retention at 30 min showed specificities of 77% and 85%, respectively. However, the normalized clearance slope increased specificity to 94% and SRn further improved it to 98%. The SRn takes into account the renal uptake curve, whose slope is dependent on glomerular function, and thus may correct for renal dysfunction. It also differentiates obstructed from patent kidneys even in cases with significant collecting system dilatation. As shown by regression analysis, it is independent of collecting system size. We recommend the routine use of this parameter to reduce false-positive and indeterminate results of diuretic renograms.

Adolescent↗
PubMed1996

Suspected obstructive pyelocaliectasis: Doppler ultrasonography compared with diuretic renal scintigraphy in proven cases.

OBJECTIVE: To compare Doppler ultrasonography with diuretic renal scintigraphy in the differentiation of obstructive from nonobstructive pyelocaliectasis. PATIENTS AND METHOD: The authors reviewed the findings of Doppler ultrasonography and diuretic renal scintigraphy performed over a 3-year period for 27 pyelocaliectatic kidneys (17 obstructed and 10 unobstructed) in 20 individuals ranging in age from 19 to 88 years. The kidneys were classified as "obstructed" or "unobstructed" on the basis of the resistive index as calculated from Doppler ultrasonographic results and as "obstructed", "unobstructed" or "indeterminate" on the basis of the clearance half-time determined from scintigraphic findings. RESULTS: On the basis of scintigraphy, the obstruction status was indeterminate in 12 of the 27 kidneys. The data were analysed for sensitivity and specificity in two ways, first by classifying the kidneys with indeterminate obstruction status as "obstructed, " and then by excluding them from the analysis altogether. In both situations, the differences in sensitivity and specificity between Doppler ultrasonography and scintigraphy were not statistically significant (chi 2 test, p > 0.05). When the kidneys with indeterminate obstruction status were included in the obstructed category, the sensitivity and specificity of Doppler ultrasonography were 94% and 90% respectively and of scintigraphy 100% and 70% respectively; when the kidneys with indeterminate obstruction status were excluded, the sensitivity and specificity of Doppler ultrasonography were 83% and 89% respectively and of scintigraphy 100% and 78% respectively. CONCLUSIONS: These results suggest that Doppler ultrasonography is comparable to diuretic renal scintigraphy in the work-up of potential obstructive pyelocaliectasis. Because grey-scale ultrasonography is usually performed before scintigraphy, a Doppler examination could be added at this stage, which might reduce the time necessary to establish the diagnosis.

Adult↗
PubMed1999

Mannitol and frusemide in the treatment of diuretic resistant oedema in nephrotic syndrome.

Three children (two girls aged 7 and 9 years, and one boy aged 4 years) with diuretic resistant oedema in steroid resistant nephrotic syndrome were treated with a combination of intravenous mannitol and frusemide. All three responded with loss of oedema of 10% to 30% of body weight over one week. There were no complications of hypertension or hypovolaemia. Mannitol-frusemide combination is a safe, inexpensive, and effective treatment for diuretic resistant oedema. Its use in other conditions and in developing countries (where the availability and purity of 20% albumin is limited) needs to be explored.

Child↗
PubMed1964

SULFONAMYL DIURETICS--MECHANISM OF ACTION AND THERAPEUTIC USE.

The mechanism whereby sulfonamyl diuretics are effective is through the blockage of the renal tubular reabsorption of chloride. The excretion of sodium, potassium and water is a passive one to maintain ionic equilibrium. Chlorothiazide has been shown to be almost ineffective as a diuretic agent per se. Although it does block a moiety of the renal tubular reabsorption of bicarbonate, the effect is merely a transient one.

Acetazolamide↗
PubMed1964

CLINICAL EXPERIENCE WITH A NEW DIURETIC, TRIAMTERENE, IN CONJESTIVE HEART FAILURE.

Triamterene therapy was evaluated in 35 patients with congestive heart failure over a period of two and one-half years. The parameters used were: clinical assessment; daily 24-hour urine sodium, potassium, chloride, and total volume; bi-weekly serum sodium, potassium, chloride, uric acid, and SGOT; hemogram, and BUN.Triamterene is a moderately potent diuretic and natriuretic, with the added desirable property of potassium conservation. It acts synergistically with spironolactone and not only potentiates the effects of hydrochlorothiazide but greatly minimizes its kaluretic effect.It is particularly useful in patients in whom cardiac arrhythmias are associated with digitalis intoxication or with inadvertently induced hypokalemia. Its main therapeutic value, used either alone or in combination with other diuretics, is in the longterm management of chronic edema, especially in certain patients refractory to the currently used diuretics.No significant undesirable side effects were noted.

Arrhythmias, Cardiac↗
PubMed1990

[Diuretics].

The pharmacology of the commonly used diuretic agents is reviewed, with special reference to the "high ceiling" diuretics and the benzothiadiazines, which are widely used in veterinary medicine. The different clinical indications in veterinary medicine are discussed.

Animals↗
PubMed1998

Diuretic-based treatment and cardiovascular events in patients with mild renal dysfunction enrolled in the systolic hypertension in the elderly program.

BACKGROUND: It is expected that the treatment of hypertension in patients with renal disease decreases the risk of cardiovascular events, but the evidence in these patients is lacking. OBJECTIVE: To assess the effect of diuretic-based treatment on cardiovascular events in patients with isolated systolic hypertension and renal dysfunction. METHODS: A total of 4336 persons aged 60 years and older with systolic blood pressures of 160 mm Hg and higher and diastolic blood pressures of less than 90 mm Hg were randomly assigned to receive either placebo or chlorthalidone (12.5-25.0 mg/d), with the addition of atenolol (25-50 mg/d) or reserpine (0.05-0.10 mg/d) if needed, and observed for 5 years. The risk of first-occurring cardiovascular events, including stroke, transient ischemic attack, myocardial infarction, heart failure, coronary artery bypass surgery, angioplasty, aneurysm, endarterectomy, sudden death, or rapid death, was stratified according to baseline serum creatinine levels (35.4-84.0, 84.1-101.6, 101.7-119.3, and 119.4-212.2 micromol/L [0.4-0.9, 1.0-1.1, 1.2-1.3, and 1.4-2.4 mg/dL]). RESULTS: Systolic blood pressure reduction was not affected by baseline serum creatinine levels. Active treatment did not affect the risk of serum creatinine levels becoming elevated during follow-up. The risk of hypokalemia with active treatment decreased significantly with increasing baseline serum creatinine levels. In the 4 baseline serum creatinine groups, the relative risk (95% confidence interval) of cardiovascular events developing with active treatment was 0.73 (0.54-0.97), 0.63 (0.49-0.82), 0.62 (0.44-0.87), and 0.59 (0.38-0.91). The results were similar for the outcomes of stroke or coronary artery events and in analyses stratified by sex or age. CONCLUSION: Diuretic-based treatment of patients with isolated systolic hypertension prevents the development of cardiovascular events in older persons with mild renal dysfunction.

Aged↗