Drug and Kidney InteractionsDiuretics 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.

Pu = polyuria (excessive urination)

Pd = Polydipsia (excessive thirst)

This produces the first symptoms of diabetes, pu/pd. What is pu/pd???

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.