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image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao The Clinical Investi...arrow_drop_down
image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
The Clinical Investigator
Article . 1994 . Peer-reviewed
License: Springer TDM
Data sources: Crossref
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Resistance to diuretics

Authors: B D, Rose;

Resistance to diuretics

Abstract

Diuretics act by decreasing sodium reabsorption via inhibition of the entry of luminal sodium into the tubular cell. The various nephron segments have different mechanisms of sodium entry, and it is this characteristic that determines the site at which the diuretic acts. The site of action is also an important determinant of diuretic potency, which is affected both by the quantity of sodium normally reabsorbed at that site and by the ability of the more distal segments to increase their rate of reabsorption in response to the increment in sodium delivery [9]. (a) Loop diuretics (such as furosemide and bumetanide) act by competing for the chloride site on the Na-K-2C1 transporter. These agents are potent diuretics that, in maximum dosage, can lead to the excretion of as much as 20-25% of the filtered sodium. This response is related to the fact that the loop normally reabsorbs 30-35% of the filtered sodium, and that the distal and collecting tubules have a limited ability to reclaim the excess sodium delivered out of the loop of Henle. (b) Thiazide-type diuretics compete for the chloride site on a Na-C1 cotransporter in the luminal membrane of the distal tubule. This segment normally reabsorbs about 5% of the filtered sodium; as a result, the thiazide diuretics are less potent than the loop diuretics. (c) With potassium-sparing diuretics, sodium entry in the principal cells in the cortical collecting tubule and in the medullary collecting tubule is mediated by selective sodium channels. The potassium-sparing diuretics, directly or indirectly, close these sodium channels. These agents are relatively weak diuretics and are used primarily to minimize urinary potassium loss.

Keywords

Drug Resistance, Humans, Kidney Diseases, Diuretics

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
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