Effects of Chlorothiazide on Renal Hemodynamics

Villarreal, H; Revollo, Andrés; Exaire, J. Emilio; Larrondo, Francisco Javier Ocharan

doi:10.1161/01.cir.26.3.409

Cited by 26 publications

(13 citation statements)

References 7 publications

(2 reference statements)

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“…Several pharmacodynamic features render this class of diuretics relatively safe in long-term treatment. For example, they prevent calcium loss -in contrast to loop diuretics -which might be dangerous in osteoporosis of the elderly [5,21]; and they maintain tubulo-glomerular balance and thus impede rapid volume depletion [30]. Thiazides are, however, relatively K + wasting [9,11].…”

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confidence: 99%

The saluretic effect of the thiazide diuretic bemetizide in relation to the glomerular filtration rate

Knauf

Cawello

Schmidt

et al. 1994

Eur J Clin Pharmacol

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The effect of the thiazide diuretic, bemetizide, on the excretion of Na+, K+, Cl-, Ca2+, and Mg2+ in relation to the glomerular filtration rate (GFR) was studied in 17 subjects whose creatinine clearances ranged from 133 to 5 ml.min-1. After a 2-day fluid and salt balanced control period, 25 mg bemetizide given orally induced natriuresis and kaliuresis which lasted for 24 h and were proportional to the GFR of the patients. The ratio of bemetizide-induced K+/Na+ excretion was always 0.17 irrespective of individual GFR. In renal failure, bemetizide increased the fractional Na+ excretion from 3% to about 10%. Kaliuresis was associated with magnesiuria, whereas bemetizide-induced calciuresis was insignificant. The thiazide reversibly lowered GFR in all subjects.

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confidence: 99%

The saluretic effect of the thiazide diuretic bemetizide in relation to the glomerular filtration rate

Knauf

Cawello

Schmidt

et al. 1994

Eur J Clin Pharmacol

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“…They indicate that the effects of frusemide and chlorothiazide are not identical under these circumstances. Single doses of chlorothiazide in man cause a fall in cardiac output, renal plasma flow and glomerular filtration rate (Crosley et al, 1960;Villareal et al, 1962). Similar studies with frusemide have shown a rise in renal blood flow and glomerular filtration rate (Buchborn & Anastasakis, 1964;Schirmeister & Willman, 1964;Heidland et al, 1964b;Vorburger, 1964;Jahnecke, Konietzko & Kruck, 1964).…”

Section: Discussionmentioning

confidence: 97%

Observations of Renal Function in Patients Undergoing Therapeutic Diuresis with Frusemide

1970

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1.Changes in extracellular water, plasma volume, blood urea and glomerular filtration rate were recorded over intervals of up to 28 days in ten patients requiring diuretic therapy, eight of whom were oedematous and none of whom had obvious renal disease.2. Diuresis with frusemide was invariably associated with a fall in extracellular water and, in all but one instance, with a fall in plasma volume. It was also associated in every case with a rise in blood urea and fall in glomerular filtration rate.3. The fall in glomerular filtration rate was observed when the extracellular water and the plasma volume of each patient was still within the 'normal' range predicted on the basis of dry weight.4. Cessation of treatment was followed by a return to initial levels of the plasma volume and extracellular water, blood urea and glomerular filtration rate.5. When body weight became stable during the administration of frusemide, there was a partial re-expansion of the plasma volume and a tendency for the glomerular filtration rate to rise.6. The mechanism whereby these changes in renal function are brought about is unknown.

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“…There is also a hypotensive action which cannot be solely explained by relating it to increased salt excretion (Pickering et al, 1961 ;Villarreal et al, 1962). A possible disadvantage is that there may be an excessive potassium loss.…”

Section: Discussionmentioning

confidence: 99%

Controlled Trial of Chlorothiazide in Treatment of Early Pre-eclampsia

Menzies¹

1964

BMJ

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MEDICALOURL 7391960) and a central effect (Gillespie et alc., 1962) may play some part. Agar et al. (1958) discussed the underlying theories of pre-eclamptic hypertension production in view of mecamylamine and the ganglion-blocking hypotensive agents being ineffectual in controlling this condition. Recently, Senior et al. (1963) have suggested that 5-hydroxytryptamine (serotonin) may have some role in the production of toxaemia of pregnancy and that antagonists of this substance may be of value in treatment. It is of interest that methyldopa interferes with the formation of serotonin in the body (Oates et al., 1960). SummaryMethyldopa and the chlorothiazide diuretics have been used in 15 patients with severe pre-eclamptic toxaemia. All but one showed a marked and satisfactory fall in blood-pressure, a diminution in proteinuria, and improvement in well-being.The foetus died early in treatment in three patients. All three had severe toxaemia occurring early in the third trimester and showed blood ureas above normal-one of them had the unsuccessful blood-pressure response. The other patients were able to continue with the pregnancies and all were delivered of healthy normal babies except one baby who died of an obstetric cause.The dose of methyldopa was relatively small and the only complication was a drug rash, but other drugs were being given at the same time. However, the number of patients was small and other side-effects may occur. No deterioration has been noted in following the condition of these patients.We should like to thank Mr. Alan Brews for permission to publish his cases. Gillespie, L., Oates, J. A., Crout, J. R., and Sjoerdsma, A. (1962).Circulation, 25, 281.Hamilton, M., and Kopelman, H. (1963). Brit. med. 7.,1, 151. Landesman, R., Ollstein, R. N., and Quinton, K. J. (1959 Pre-eclampsia remains a common complication of pregnancy in this country. Although the foetal wastage appears to be slightly less now than ten years ago, the figures from the National Birthday Trust Perinatal Mortality Survey show that in pregnancies resulting in stillbirth or neonatal death there is still a raised incidence of pre-eclampsia (D. G. Bonham, personal communication, 1963). It is also one of the three most common features of the history where the mother has died ; 18% of maternal deaths are associated with pre-eclampsia (Ministry of Health, 1963).In spite of the importance of the condition the cause remains obscure, and treatment, although relatively successful, is still largely empirical. Hypotensive drugs may have value if given early in pregnancy, but this treatment is possible only for those women who show early hypertension. In cases of non-toxaemic hypertension reserpine seems to have a place but does not reduce foetal loss (Landesman and Ollstein, 1958). In true preeclampsia hypotensive drugs can only be given late and the results are disappointing. A large number of clinicians still rely on prescribing a sedative and advising bed rest, and of these two methods rest in bed is the least empirical. It is kno...

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Effects of Chlorothiazide on Renal Hemodynamics

Cited by 26 publications

References 7 publications

The saluretic effect of the thiazide diuretic bemetizide in relation to the glomerular filtration rate

The saluretic effect of the thiazide diuretic bemetizide in relation to the glomerular filtration rate

Observations of Renal Function in Patients Undergoing Therapeutic Diuresis with Frusemide

Controlled Trial of Chlorothiazide in Treatment of Early Pre-eclampsia

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