Physiology and Pathophysiology of Diuretic Action

Ellison, David H.

doi:10.1016/b978-0-12-381462-3.00040-9

Cited by 6 publications

(3 citation statements)

References 316 publications

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“…The most common clinical scenario in which this phenomenon is encountered is loop diuretic resistance (Figure 4) (37). Chronic treatment with diuretics that inhibit the Na-K-2Cl cotransporter in the loop of Henle (bumetanide-sensitive sodium-potassium-chloride cotransporter [NKCC2, SLC12A1]), such as furosemide, results in a sustained increase in luminal Na 1 delivery to the DCT.…”

Section: Regulation Of Nacl Transport In the Dctmentioning

confidence: 99%

Distal Convoluted Tubule

Subramanya

Ellison

2014

Clinical Journal of the American Society of Nephrology

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The distal convoluted tubule is the nephron segment that lies immediately downstream of the macula densa. Although short in length, the distal convoluted tubule plays a critical role in sodium, potassium, and divalent cation homeostasis. Recent genetic and physiologic studies have greatly expanded our understanding of how the distal convoluted tubule regulates these processes at the molecular level. This article provides an update on the distal convoluted tubule, highlighting concepts and pathophysiology relevant to clinical practice.

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Section: Regulation Of Nacl Transport In the Dctmentioning

confidence: 99%

Distal Convoluted Tubule

Subramanya

Ellison

2014

Clinical Journal of the American Society of Nephrology

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220

185

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“…Studies have shown that a strategy of water restriction and removal of excess body water, which is known as extravascular lung water (EVLW), reduces the time on mechanical ventilation [20][21][22][23] and improves survival rates [24][25][26][27][28]. The use of pharmacological measures such as the use of furosemide is indicated, but in some cases where the response to diuretic use is limited or sometimes inadequate [29,30] and the patient's condition is very severe, using some method of extracorporeal therapy is justified in order to achieve rapid negative water balance thus improving oxygenation rates.…”

Section: Role Of Extracorporeal Therapies In the Management Of Criticmentioning

confidence: 99%

33rd Vicenza Course on Critical Care Nephrology. Vicenza, June 9-12, 2015: Abstracts

2015

Blood Purif

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Background: Time to reperfusion and acute kidney injury (AKI) are powerful prognostic markers in ST segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI), however no information to date is present regarding the association between time to reperfusion and AKI. We evaluated whether time to reperfusion predicts the risk of AKI among STEMI patients undergoing primary PCI.Methods: Medical records of 417 patients admitted to our department between January 2006 and July 2013, for STEMI and treated with primary PCI were reviewed. Patients' were stratified by time to reperfusion tertiles and their records were assessed for the occurrence of AKI following PCI.Results: Mean age was 61 ± 13 years and 346 (83%) were male. The cut-off points for the time to reperfusion tertiles were <120 minutes, 120-300 minutes, and >300 minutes. Patients having longer time to reperfusion had more AKI complicating the course of STEMI (3% vs. 11% vs. 13%, p = 0.007) and had significantly higher serum creatinine change throughout hospitalization (0.13 mg/ dl vs. 0.18 mg/dl vs.0.21 mg/dl p < 0.001). In a multivariable logistic regression model time to reperfusion emerged as an independent predictor of AKI (OR 1.001, 95% CI 1.000-1.001, p = 0.04).Conclusion: Longer time to reperfusion in is an independent risk factor for the development of AKI in STEMI patients undergoing primary PCI.

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“…2 Another drawback of loop diuretics is their short human half-lives (i.e., furosemide human half-life ∼2 h), which are associated with robust initial diuretic responses (impacting tolerability) followed by rebound effects; short half-lives may also be responsible for the inferior blood pressure efficacy of loop diuretics compared to longer half-life thiazide diuretics. 3 Despite the established importance of these therapies and the opportunity for improvement over existing therapeutics, no new diuretics have been disclosed to be in development.…”

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confidence: 99%