The target‐specific transporter and current status of diuretics as antihypertensive

Ali, Syed Salman; Sharma, Pramod Kumar; Garg, Veena; Singh, Asheesh Kumar; Mondal, Sambhu Charan

doi:10.1111/j.1472-8206.2011.01012.x

Cited by 10 publications

(12 citation statements)

References 31 publications

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“…Approximately 98% of furosemide bounds to plasma proteins and the GFR of the drug is very low 18,19. Hence, for exerting this effect, it is necessary that furosemide should be actively secreted from the proximal tubule via the organic anion transporter-1 20,21. In point of fact, the response to furosemide is directly related to its urinary concentrations 20.…”

Section: Discussionmentioning

confidence: 99%

“…Hence, for exerting this effect, it is necessary that furosemide should be actively secreted from the proximal tubule via the organic anion transporter-1 20,21. In point of fact, the response to furosemide is directly related to its urinary concentrations 20. At severe renal injury, this transporting capacity of proximal tubule may be affected extensively; moreover, at such patient the furosemide may not be able to reach to its action site.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prophylactic furosemide infusion decreasing early major postoperative renal dysfunction in on-pump adult cardiac surgery: a randomized clinical trial

Fakhari¹,

Bavil²,

Bilehjani³

et al. 2017

RRU

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IntroductionAcute renal dysfunction is a common complication of cardiac surgery. Furosemide is used in prevention, or treatment, of acute renal dysfunction. This study was conducted to evaluate the protective effects of intra- and early postoperative furosemide infusion on preventing acute renal dysfunction in elective adult cardiac surgery.MethodsEighty-one patients, candidates of elective cardiac surgery, were enrolled in this study in either the furosemide (n=41) or placebo (n=40) group. Furosemide (2 mg/h) or 0.9% saline was administered and continued up to 12 hours postoperatively. We measured serum creatinine (Scr) at preoperative and on the second and fifth postoperative days. Then calculated estimated glomerular filtration rate (eGFR) at these times. An increase in Scr of >0.5 mg/dL and/or >25%–50%, compared to preoperative values, was considered as acute kidney injury (AKI). In contrast, an increase in Scr by >50% and/or the need for hemodialysis was regarded as acute renal failure (ARF). At the end we compared the AKI or ARF incidence between the two groups.ResultsOn the second and fifth postoperative days, Scr was lower, and the eGFR was higher in the furosemide group. AKI incidence was similar in the two groups (11 vs 12 cases; P-value 0.622); however, ARF rate was lower in furosemide group (1 vs 6 cases; P-value 0.044). During the study period, Scr was more stable in the furosemide group, however in the placebo group, Scr initially increased and then decreased to its preoperative value after a few days.ConclusionThis study showed that intra- and early postoperative furosemide infusion has a renal protective effect in adult cardiac surgery with cardiopulmonary bypass. Although this protective effect cannot be discovered in mild renal dysfunctions, it apparently reduces the rate of the more severe renal dysfunctions. A more multidisciplinary strategy may be needed in reducing the milder renal damage.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prophylactic furosemide infusion decreasing early major postoperative renal dysfunction in on-pump adult cardiac surgery: a randomized clinical trial

Fakhari¹,

Bavil²,

Bilehjani³

et al. 2017

RRU

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“…Diuretics are a heterogeneous group of drugs, and with the exception of vasopressin receptor antagonists and mannitol, their primary action is to impair sodium reabsorption at different sites along the tubule, thereby increasing urinary excretion of sodium and chloride and inducing increased water excretion 98,99 . Different types of diuretics are available and this review will focus on loop, thiazide and potassium‐sparing diuretics (PSD).…”

Section: Diureticsmentioning

confidence: 99%

Renal haemodynamic and protective effects of renoactive drugs in type 2 diabetes: Interaction with SGLT2 inhibitors

et al. 2021

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Diabetic kidney disease remains the leading cause of end‐stage kidney disease and a major risk factor for cardiovascular disease. Large cardiovascular outcome trials and dedicated kidney trials have shown that sodium‐glucose cotransporter (SGLT)2 inhibitors reduce cardiovascular morbidity and mortality and attenuate hard renal outcomes in patients with type 2 diabetes (T2D). Underlying mechanisms explaining these renal benefits may be mediated by decreased glomerular hypertension, possibly by vasodilation of the post‐glomerular arteriole. People with T2D often receive several different drugs, some of which could also impact the renal vasculature, and could therefore modify both renal efficacy and safety of SGLT2 inhibition. The most commonly prescribed drugs that could interact with SGLT2 inhibitors on renal haemodynamic function include renin‐angiotensin system inhibitors, calcium channel blockers and diuretics. Herein, we review the effects of these drugs on renal haemodynamic function in people with T2D and focus on studies that measured glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) with gold‐standard techniques. In addition, we posit, based on these observations, potential interactions with SGLT2 inhibitors with an emphasis on efficacy and safety.

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“…Recently, integration of genetics and molecular cloning of the diuretic‐sensitive sodium transporters in the convoluted tubule has improved the understanding of the cellular mechanisms of action and has led to new targets for safer and more efficacious diuretics. Some targets that have been identified and are being assessed include pendrin and the renal outer medullary K + channel, ROMK.…”

Section: Diureticsmentioning

confidence: 99%

Drugs and the Kidneys: Clinical Pharmacology Perspectives

Vincent

2017

Clin Pharma and Therapeutics

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The focus of this edition of Clinical Pharmacolgoy & Therapeutics (CPT) is on drugs and renal function and will not include a detailed discussion of kidney disease and its treatment. It is well recognized that drugs affect the kidneys in different ways, while kidney disease impacts drug metabolism and response. It is impossible to underestimate the value of the kidneys to man in health and disease, from regulation of fluid and electrolyte balance to participating in drug metabolism and transport. Additionally, the kidneys serve as targets for drugs used to treat cardiovascular (CV) diseases including hypertension and heart failure, metabolic diseases such as diabetes mellitus and obesity, chronic kidney disease (CKD), as well as playing a role in the regulation of several hormones. Kidney damage may be distinguished from changes in kidney function using biomarkers, as discussed in some detail in this issue.

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The target‐specific transporter and current status of diuretics as antihypertensive

Cited by 10 publications

References 31 publications

Prophylactic furosemide infusion decreasing early major postoperative renal dysfunction in on-pump adult cardiac surgery: a randomized clinical trial

Prophylactic furosemide infusion decreasing early major postoperative renal dysfunction in on-pump adult cardiac surgery: a randomized clinical trial

Renal haemodynamic and protective effects of renoactive drugs in type 2 diabetes: Interaction with SGLT2 inhibitors

Drugs and the Kidneys: Clinical Pharmacology Perspectives

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