Page 289 - Basic _ Clinical Pharmacology ( PDFDrive )

CHAPTER 15 Diuretic Agents 275

Takeuchi T et al: Diuretic effects of sodium-glucose cotransporter 2 inhibitor in Vasilakou D et al: Sodium-glucose cotransporter 2 inhibitors for type 2 diabetes: A
patients with type 2 diabetes mellitus and heart failure. Int J Cardiol 2015;201:1. systematic review and meta-analysis. Ann Intern Med 2013;159:262.
Tavares M et al: New pharmacologic therapies in acute heart failure. Crit Care Verkman AS et al: Small-molecule inhibitors of urea transporters. Subcell Biochem
Med 2008;36:S112. 2014;73:165.
Tovar-Palacio C et al: Ion and diuretic specificity of chimeric proteins between apical Wakai A, Roberts I, Schierhout G: Mannitol for acute traumatic brain injury.
+
+
−
−
+
Na -K -2Cl and Na -Cl cotransporters. Am J Physiol 2004;287:F570. Cochrane Database Syst Rev. 2007;1:CD001049.
Vaclavik J et al: Effect of spironolactone in resistant arterial hypertension: A Wilcox C: New insights into diuretic use in patients with chronic renal disease.
randomized, double-blind, placebo-controlled trial (ASPIRANT-EXT). J Am Soc Nephrol 2002;13:798.
Medicine (Baltimore) 2014;93:e162.
C ASE STUD Y ANSWER

This patient demonstrates the dramatic diuresis that can be patient with preexisting advanced kidney disease. This case
achieved in patients on chronic loop diuretic therapy after demonstrates the need for very close monitoring of patients
addition of a thiazide diuretic. The drop in systolic blood after addition of thiazide diuretics to chronic loop diuretic
pressure and the weight loss are consistent with the rapid therapy (particularly if they have pre-existing chronic kid-
diuresis achieved in this patient, with hypovolemia follow- ney disease). This is often best achieved in the inpatient
ing. This effect has now led to acute kidney injury in this setting.