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Drug and Kidney Interactions
Diuretics and Anti-diuretics
Diuretics
• Drugs or substances that increase
diuresis, or urine output
Diabetes and diuresis
• Diabetics lack the ability to allow
glucose to enter body cells
• As a result, diabetics may have high
levels of glucose in their blood
• Some of the glucose will leave the
blood and enter the kidney nephron
High Blood Glucose as a diuretic:
High glucose levels in the nephron makes the
interior hypertonic to the exterior. Water will
move into the nephron by osmosis.
This produces the first symptoms of diabetes,
pu/pd. What is pu/pd???
Pd = Polydipsia (excessive
Pu = polyuria (excessive thirst)
urination)
Certain medical conditions create a
need for diuretics:
•
•
•
•
Congestive Heart Failure (CHF)
High Blood Pressure
Kidney and liver problems
glaucoma
Lasix (furosemide) relieves strain on the
heart by increasing urine output. This
removes extra fluid from the blood. The
heart does not have to work as hard.
Lasix creates a hypertonic solution in the
nephron so that water enters the nephron by
osmosis and can be eliminated
Lasix inhibits
transport of
ions and
therefore,
maintains a
hypertonic
solution in
the nephron.
This
prevents
water from
being
reabsorbed
into the
blood by
osmosis.
Caffeine: Inhibits the reabsorption of sodium,
creating a hypertonic solution inside the nephron.
This also prevents the reabsorption of water by
osmosis. Water will be pulled into the nephron
rather than removed from the nephron.
Anti-diuretics: prevent excessive urination
ADH: Anti-diuretic Hormone
With ADH present, 99% of water is
reabsorbed. ADH release in the body
should maintain homeostasis.
Certain conditions cause the body to
increase its production of ADH.
Sweating: excess loss of fluids
creates the need for the kidneys
to recycle more water
Diarrhea: The large intestine is not absorbing
water so the kidneys must compensate by
increasing their reabsorption of water.
Hypovolemia: low blood volume due to
excessive traumatic blood loss
When an injury causes severe bleeding,
the body releases ADH in an attempt to
increase the amount of water retained in
order to increase blood volume.
Or Vampires!
ADH and Bed-wetting:
• Some children experience bed-wetting because of
low levels of ADH
• They may be given a prescription form of the
hormone to fix the problem.