Abstract
The clinical use of diuretics should be based on a good understanding of the pathophysiology of edema and the disease being treated, the pharmacology of the diuretics and their reported side effects. This knowledge allows one the best opportunity to effectively and safely match the mechanism of action of the diuretic to the altered physiology caused by the disease. The major clinical conditions for which diuretics have been used in the treatment of edema are shown in Table 1. It is generally agreed that, whatever the pathophysiology of the primary disease, the retention of sodium by the kidney ultimately determines the magnitude of the fluid overload and consequent edema formation. Thus, an understanding of normal salt and water handling by the kidney is essential.
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References
Pitts, R.E.: Physiology of the Kidney and Body Fluids. Chicago, Ill: Year Book Medical Publishers, Inc., 1974.
Stein, J.H. and Reineck, H.J.: Regulation of Sodium Balance in Normal and Edematous States. In Contr. Nephrol., Basel: Karger, 1978, vol. 14, p. 25.
Kinne, R.: Current Choices of Renal Proximal Tubular Function. In Contr. Nephrol., Basel: Karger, 1978, vol. 14, p. 14.
Richard, G.A., Garin, E.H., Fennell, R.S. et al.: A Pathophysiologic Basis for the Diagnosis and Treatment of the Renal Hypertensions. In Advances in Pediatrics. Chicago, Ill.: Year Book Medical Publishers, Inc., 1977, vol. 24, p. 339.
de Wardener, H.E., Mills, I.H., Clapham, W.F. et al.: Studies on the Efferent Mechanism of the Sodium Diuresis Which Follows the Administration of Intravenous Saline in the Dog. Clin. Sci. 21: 249, 1961.
Buckalen, V.M. and Nelson, D.B.: Natriuretic and Sodium Transport Inhibitory Activity in Plasma of Volume Expanded Dogs. Kidney Int. 5: 12, 1974.
Levinsky, N.G.: Non-Aldosterone Influences on Renal Sodium Transport. Ann. N.Y. Acad. Sci. 139: 295, 1966.
Brenner, R.M., Troy, J.L. and Daugharty, T.M.: Quantitative Importance of Changes in Postglomerular Colloid Osmotic Pressure in Medicating Glomerular Tubular Balance in The Rat. J. Clin. Invest. 52: 190, 1973.
Barger, A.C.: Renal Hemodynamic Factors in Congestive Heart Failure. Ann. N.Y. Acad. Sci. 139: 276, 1966.
Lamere, N.H., Lifschitz, M.D. and Stein, J.H.: Heterogeneity of Nephron Function. Ann. Rev. Physiol. 39: 159, 1977.
Earley, L.E. and Friedler, R.M.: Observations on the Mechanism of Decreased Tubular Reabsorption of Sodium and Water During Saline Loading. J. Clin. Invest. 43: 1928, 1964.
Horton, R. and Zipser, R.: Prostaglandins: Renin Release and Renal Function. In Contr. Nephrol. Basel: Karger, 1978, vol. 14, p. 87.
Starling, E.H.: Physiologic Factors Involved in the Causation of Dropsy. Lancet 2: 1405, 1896.
Cannon, P.J.: The Kidney in Heart Failure. N. Engl. J. Med. 296: 26, 1977.
Seely, J.F. and Dirks, J.H.: Site of Action of Diuretic Drugs. Kidney Int. 2: 1, 1977.
Burg, B.: Mechanisms of Action of Diuretic Drugs. In Brenner, B.M., Rector, F.C. (eds.). The Kidney. Philadelphia: W.B. Saunders Co., 1976, vol. 1, p. 737.
Dirks, J.H.: Mechanism of Action and Clinical Uses of Diuretics. Hospital Practice, vol. 13, p. 99, 1979.
Belair, E., Kaiser, F. et al.: Pharmacology of SR 720–22. Arch. Int. Pharmacodyn. 177: 71, 1969.
Van Ypersele De Strihou, C.: Metabolic Complications in the Use of Diuretics. In Advances in Nephrology. Chicago: Year Book Medical Publishers, Inc., 1972, vol. 2, p. 241.
Porter, G.: The Role of Diuretics in the Treatment of Heart Failure. JAMA, vol. 244, 1980, p. 1614.
Sherlock, S.: Diuretics in Hepatic Disease in Modern Diuretic Therapy. In Lant, A.F. and Wilson, G.M. (eds.). Excerpta Medica, Amsterdam, 1973, p. 270.
Hollerman, Charles E.: Pediatric Nephrology. New York: Medical Examination Publishing Co., Inc., 1979, p. 305.
Lewy, J.E.: The Pathogenesis of Edema in Renal Disease and Other Disorders Affecting the Kidney. In Edelmann, C.M. (ed.). Pediatric Kidney Disease. Boston: Little, Brown and Co., 1978, vol. 1, p. 315.
Loggie, J.M., Kleinman, L.I. and Van Maanen, E.F.: Renal Function and Diuretic Therapy in Infants and Children. Part III. J. Pediatr. 86: 825, 1975.
Garin, E.G. and Richard, G.A.: Edema Resistant to Furosemide Therapy in Children with Nephrotic Syndrome: Treatment with Furosemide and Metolazone. J. Pediatr. Nephrol. and Urol. (In press).
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© 1981 Plenum Press, New York
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Richard, G.A., Garin, E.H., Iravani, A., Fennell, R.S., Orak, J.K. (1981). Principles of Diuretic Therapy in Edematous Conditions. In: Strauss, J. (eds) Pediatric Nephrology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-8804-3_35
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DOI: https://doi.org/10.1007/978-1-4684-8804-3_35
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