Renu Dwivedi,
Avi Baliyan,
- Assistant Professor, School of Pharmaceutical Sciences, Bahra University, Waknaghat, Himachal Pradesh, India
- Student, School of Pharmaceutical Sciences, Bahra University, Waknaghat, Himachal Pradesh, India
Abstract
Diuretics have a rich history that spans several centuries, and this review aims to highlight their progression and clinical uses. We start by exploring kidney physiology, followed by a description of how diuretics function through symporters in the renal tubules. Different categories of diuretics are outlined, along with details of their specific actions. Next, we investigate the clinical use of diuretics in conditions such as congestive heart failure and hypertension, as well as in some less prevalent but medically important conditions. The possible side effects of diuretics, along with their underlying causes, are also addressed. Frequent adverse effects, including hypokalemia and hyponatremia, are examined in depth, along with other electrolyte disturbances like hypomagnesemia. The role of diuretics in the management of chronic kidney disease is explored, along with updates on new guidelines in this field. A segment on diuretic misuse is included, given its growing recognition in clinical settings, emphasizing the often tragic consequences of such abuse. Additionally, research is ongoing into the use of diuretics for diagnosing certain types of renal tubular acidosis. Lastly, some of the latest strategies for diuretic treatment are discussed, often stemming from advances in molecular biology, revealing new compounds that may soon enter future medication lists.
Keywords: Diuretics, Urine concentration, Thiazide diuretics, Potassium sparing, hydrochlorothiazide.
Renu Dwivedi, Avi Baliyan. The Function of Diuretics in Current Medical Practice and Prospective Advancements. Research and Reviews: A Journal of Pharmacology. 2025; 15(01):-.
Renu Dwivedi, Avi Baliyan. The Function of Diuretics in Current Medical Practice and Prospective Advancements. Research and Reviews: A Journal of Pharmacology. 2025; 15(01):-. Available from: https://journals.stmjournals.com/rrjop/article=2025/view=203507
References
- Agre, P., Preston, G. M., Smith, B. L., Jin Sup Jung, Raina, S., Moon, C., Guggino, W. B., & Nielsen, S. (1993). Aquaporin CHIP: The archetypal molecular water channel. American Journal of Physiology – Renal Fluid and Electrolyte Physiology, 265(4 34-4). https://doi.org/10.1152/ajprenal.1993.265.4.f463
- Beger, R. D., Sun, J., & Schnackenberg, L. K. (2010). Metabolomics approaches for discovering biomarkers of drug-induced hepatotoxicity and nephrotoxicity. Toxicology and Applied Pharmacology, 243(2), 154–166. https://doi.org/10.1016/j.taap.2009.11.019
- Bell, R., & Mandalia, R. (2022). Diuretics and the kidney. BJA Education, 22(6), 216–223. https://doi.org/10.1016/j.bjae.2022.02.003
- Brater, D. C. (2000). Pharmacology of diuretics. American Journal of the Medical Sciences, 319(1), 38–50. https://doi.org/10.1016/S0002-9629(15)40678-0
- Dyckner, T., & Wmr, P. (n.d.). Potassium-sparing diuretics. 1, 79–83.
- Ellison, D. H., & Felker, G. M. (2017). Diuretic Treatment in Heart Failure. New England Journal of Medicine, 377(20), 1964–1975. https://doi.org/10.1056/nejmra1703100
- Epstein, M., & Calhoun, D. A. (2011). Aldosterone blockers (mineralocorticoid receptor antagonism) and potassium-sparing diuretics. Journal of Clinical Hypertension, 13(9), 644–648. https://doi.org/10.1111/j.1751-7176.2011.00511.x
- Faris, R., Flather, M., Purcell, H., Henein, M., Poole-Wilson, P., & Coats, A. (2002). Current evidence supporting the role of diuretics in heart failure: A meta analysis of randomised controlled trials. International Journal of Cardiology, 82(2), 149–158. https://doi.org/10.1016/S0167-5273(01)00600-3
- Gade, W., & Robinson, B. (2006). A brief survey of aquaporins and their implications for renal physiology. Clinical Laboratory Science : Journal of the American Society for Medical Technology., 19(2), 70–79.
- Greenberg, A. (2000). Diuretic complications. American Journal of the Medical Sciences, 319(1), 10–24. https://doi.org/10.1016/S0002-9629(15)40676-7
- Knepper, M., & Burg, M. (1983). Organization of nephron function. American Journal of Physiology – Renal Fluid and Electrolyte Physiology, 13(6). https://doi.org/10.1152/ajprenal.1983.244.6.f579
- Krämer, B. K., Schweda, F., & Riegger, G. A. J. (1999). Diuretic treatment and diuretic resistance in heart failure. American Journal of Medicine, 106(1), 90–96. https://doi.org/10.1016/S0002-9343(98)00365-9
- Macías-Núñez, J.-F., & López-Novoa, J. M. (2007). Physiology of the Healthy Aging Kidney. The Aging Kidney in Health and Disease, 93–112. https://doi.org/10.1007/978-0-387-72659-5_5
- Nielsen S, Smith BL, Christensen EI, Agre P. Distribution of the aquaporin CHIP in secretory and resorptive epithelia and capillary endothelia. Proc Natl Acad Sci U S A. 1993 Aug 1;90(15):7275-9. doi: 10.1073/pnas.90.15.7275.
- Pashley, S. (1999). Wallace MA. Anatomy and physiology of the kidney. AORN journal. 1998 Nov 1;68(5):799-820. 68(5).
- Qavi, A. H., Kamal, R., & Schrier, R. W. (2015). Clinical use of diuretics in heart failure, cirrhosis, and nephrotic syndrome. International Journal of Nephrology, 2015. https://doi.org/10.1155/2015/975934
- Roush, G. C., Ernst, M. E., Kostis, J. B., Yeasmin, S., & Sica, D. A. (2016). Dose doubling, relative potency, and dose equivalence of potassium-sparing diuretics affecting blood pressure and serum potassium: Systematic review and meta-analyses. Journal of Hypertension, 34(1), 11–19. https://doi.org/10.1097/HJH.0000000000000762
- Salvetti, A., & Ghiadoni, L. (2006). Thiazide diuretics in the treatment of hypertension: An update. Journal of the American Society of Nephrology, 17(SUPPL. 2), 25–29. https://doi.org/10.1681/ASN.2005121329
- Schoofs, M. W. C. J., Van Der Klift, M., Hofman, A., De Laet, C. E. D. H., Herings, R. M. C., Stijnen, T., Pols, H. A. P., & Stricker, B. H. C. (2003). Thiazide Diuretics and the Risk for Hip Fracture. Annals of Internal Medicine, 139(6). https://doi.org/10.7326/0003-4819-139-6-200309160-00010
- Schrier, R. W. (2011). Use of diuretics in heart failure and cirrhosis. Seminars in Nephrology, 31(6), 503–512. https://doi.org/10.1016/j.semnephrol.2011.09.005
- Shah, S., Khatri, I., & Freis, E. D. (1978). Mechanism of antihypertensive effect of thiazide diuretics. American Heart Journal, 95(5), 611–618. https://doi.org/10.1016/0002-8703(78)90303-4
- Supuran, C. T. (2016). How many carbonic anhydrase inhibition mechanisms exist? Journal of Enzyme Inhibition and Medicinal Chemistry, 31(3), 345–360. https://doi.org/10.3109/14756366.2015.1122001
- Supuran, C. T., & Scozzafava, A. (2000). Carbonic-anhydrase inhibitors and their therapeutic potential. Expert Opinion on Therapeutic Patents, 10(5), 575–600. https://doi.org/10.1517/13543776.10.5.575
- Titko, T., Perekhoda, L., Drapak, I., & Tsapko, Y. (2020). Modern trends in diuretics development. European Journal of Medicinal Chemistry, 208, 112855. https://doi.org/10.1016/j.ejmech.2020.112855
- van Zwieten, P. A. (1992). Comparative mechanisms of action of diuretic drugs in hypertension. European Heart Journal, 13 Suppl G, 2–4. https://doi.org/10.1093/eurheartj/13.suppl_G.2
- Verkman, A. S. (2005). Novel roles of aquaporins revealed by phenotype analysis of knockout mice. Reviews of Physiology, Biochemistry and Pharmacology, 155, 31–55. https://doi.org/10.1007/s10254-005-0040-1
- Wile, D. (2012). Diuretics: A review. Annals of Clinical Biochemistry, 49(5), 419–431. https://doi.org/10.1258/acb.2011.011281
- Wittner, M., Di Stefano, A., Wangemann, P., & Greger, R. (1991). How Do Loop Diuretics Act? Drugs, 41(3), 1–13. https://doi.org/10.2165/00003495-199100413-00003
- Yool, A. J., Migliati, E. R., Creek, Q., Ritter, L. S., & Data, R. U. S. A. (2011). (12) United States Patent. 2(12).
- Zhuo, J. L., & Li, X. C. (2013). Proximal nephron. Comprehensive Physiology, 3(3), 1079–1123. https://doi.org/10.1002/cphy.c110061

Research and Reviews: A Journal of Pharmacology
| Volume | 15 |
| 01 | |
| Received | 18/02/2025 |
| Accepted | 10/03/2025 |
| Published | 12/03/2025 |
| Publication Time | 22 Days |
PlumX Metrics
