Diuretics : basic, pharmacological, and clinical aspects : proceedings of the International Meeting on Diuretics, Sorrento, Italy, May 26-30, 1986

The need for adequate means by which to improve urine output is very old. Even in the "Scuola Salernitana", the oldest medieval medical school in Western Europe, about 1000 years ago it was taught how to improve urine output. The list of known "diuretica" included herbs, plants, roots, vegetables, in particular asparagus, fennel and carrot. The first diuretic drugs, however, were mercurial compounds. Thus, calomel, mercurous chloride, was initially used as a diuretic in the sixteenth century by Paracelsus, being one of the ingredients of the so-called "Guy's Hospital pill". But calomel had a cathartic effect so that it was replaced by organic mercurial compounds. These diuretics were clearly toxic. After the discovery of the car­ bonic anhydrase, in the early 1930s, and the introduction of sulfanilamide as a chemotherapeutic agent, it was observed that this drug was inhibiting carbonic anhydrase in vitro and urinary acidification in vivo thereby causing metabolic acidosis; urine output, however, appeared to increase. Subsequent studies led to the synthesis of more potent analogs, in particular acetazolamide. Studies on car­ bonic anhydrase inhibitors led to the synthesis of benzothiadiazides which disclosed much less inactivating action on carbonic anhydrase and much more diuretic effect through an inhibition of tubular transport of sodium and chloride. Chlorothiazide was the first member of this class of diuretics. Thiazides are still used in clinical practice. Front Matter....Pages i-lv Front Matter....Pages 1-1 Diuretics in the Salernitan Medicine....Pages 3-8 Front Matter....Pages 9-9 Ion Transport and Metabolism in Renal Cells....Pages 11-20 Hydrogen Secretion Regulated by Intracellular Membrane Potential: A Hypothesis on the Regulation of Renal Acidification....Pages 21-26 Isolation and Purification of the Amiloride-Sensitive Na + Channel from Renal Epithelia....Pages 27-32 Blockers of Active Transport in the Thick Ascending Limb of the Loop of Henle....Pages 33-38 The Use of Amiloride Analogs to Probe Adaptations of the Proximal Tubuiar Na + /H + Antiporter in Response to a Reduction in Renal Mass....Pages 39-46 Red Blood Cell Na + -Transport, Na-K-ATPase and Phosphate Ester Metabolism in Essential Hypertension....Pages 47-49 Correlation between Blood Pressure and K + Fluxes in Essential Hypertensive Patients Treated For 2 Years with Cicletanine....Pages 50-52 Effects of Muzolimine on Cation Transport in Human Erythrocytes....Pages 53-55 Effects of Xipamide on Transmembranary Potassium Movements and Prostacyclin Production....Pages 56-58 Lack of Evidence for Na/K ATPase Inhibition as a Cause of Low Renin Human Hypertension....Pages 59-61 Canrenone Prevents Na,K Pump Inhibition Induced by Volume Expansion in Normal Subjects....Pages 62-64 Effect of Thiazides and Amiloride on the Phosphorylation Status of the Red Cell Membrane Anion Carrier....Pages 65-67 In Vitro Effects of d(+) And l(-) Ozolinone on Sodium and Potassium Fluxes in Human Erythrocytes....Pages 68-70 Front Matter....Pages 71-71 The Effects of Diuretics on Salt Transport in Renal Diluting Segments....Pages 73-78 Estimation of Free Water Back Diffusion during Water Diuresis in Man Using Lithium Clearance and Furosemide Effect: Some Unresolved Questions....Pages 79-81 Effect of Ouabain and Acetazolamide on Proximal Tubular Transport in Dogs....Pages 82-84 Voltage-Driven Calcium Reabsorption in Diluting Segment: INHIBITION by Furosemide but Not by Calcium Antagonists....Pages 85-87 Relationship between Na,K-ATPse Activity and Transcellular Nacl Reabsorption in Dog Kidneys....Pages 88-90 Dose Dependence of Inhibition of Proximal Tubular Sodium Reabsorption by Furosemide in Conscious Rats....Pages 91-94 Front Matter....Pages 71-71 Modification in Renal Handling of Phosphate Induced by Hydrochlorothiazide (HCTZ) and Amiloride (A)....Pages 95-97 Front Matter....Pages 99-99 Influence of Renal Failure on the Pharmacokinetics of Cicletanine....Pages 101-103 Pharmacokinetics and -Dynamics of Piretanide in Chronic Renal Failure....Pages 104-106 Changes in Furosemide Pharmacokinetics Induced by Dehydration....Pages 107-109 Pharmacokinetics of Torasemide in Man....Pages 110-112 Furosemide Blunts Hydrochlorothiazide (HCT) Effect....Pages 113-115 Influence of Renal Insufficiency on the Pharmacokinetics and the Renal Effects of Cicletanine....Pages 116-118 A Comparison between Torasemide and Furosemide Effects after Application Upon One Kidney or after I.V. Injection in the Rat....Pages 119-121 Front Matter....Pages 123-123 Receptor Binding Sites of Atrial Natriuretic Factor in Bovine Brain Microvessels....Pages 125-127 Intrarenal Localization and Photoaffinity Labeling of Receptors for α-Rat Atrial Natriuretic Polypeptide....Pages 128-130 Atrial Natriuretic Peptide Raise Hematocrit in Conscious Nephrectomized Rats....Pages 131-133 Tubular Effects of Atrial Extract and of Atriopeptin III in Conscious Rats....Pages 134-136 Atrial Natriuretic Peptides and Renin Secretion....Pages 137-139 Salt Loading in Spontaneously Hypertensive Rats Further Elevates Blood Pressure Despite Enhanced Release of Atrial Natriuretic Peptides and Exaggerated Natriuresis....Pages 140-144 Plasma Cardionatrin and Volume and the Renin Angiotensin Aldosterone System in Normotensiye and Hypertensive Pregnancy....Pages 145-147 Atrial Natriuretic Peptide as an Indicator of Cardiac and Volume State....Pages 148-150 Atrial Natriuretic Peptides (ANP) in Rats with Chronic Renal Failure....Pages 151-155 Plasma Levels of Human Atrial Natriuretic Peptide in Chronic Uremic Patients....Pages 156-158 Atrial Natriuretic Peptide (ANP) and Renal Function: Effect of Posture and Dietary Sodium....Pages 159-161 Involvement of Na + Transport and Natriuretic Hormones in the Antihypertensive Mechanism of Canrenone....Pages 162-164 Front Matter....Pages 123-123 Inhibition of the Erythrocyte Na + , K + -Pump by Mammalian Lignans: A Possible Link with Endogenous Digitalis....Pages 165-167 Effects of Human Alfa Natriuretic Atrial Peptide on Aldosterone Secretion in Vitro....Pages 168-170 Interaction of Platelet-Activating Factor with Natriuresis and Diuresis Induced by the Synthetic Atrial Natriuretic Factor [Ser 99 - Tyr 126] in Anaesthetized Dog....Pages 171-173 Circulating Natriuretic Factor in the Pathogenesis of Genetic Hypertension of Renal Origin....Pages 174-176 Lack of Correlation between Plasma Ouabain-Like Factor and Urinary Sodium Excretion in Essential Hypertensive Patients....Pages 177-179 Atrial Natriuretic Peptide during Water Immersion in Healthy Volunteers....Pages 180-182 Front Matter....Pages 183-183 Symposium on Aquaretics: Introduction....Pages 185-187 Some Aquarectic Agents other than Vasopressin Analogs....Pages 188-195 Vasopressin Antagonists: Model Aquaretic Agents....Pages 196-202 The Anti-Antidiuretic Effect of a Stable Prostaglandin-E 2 Analog in Conscious Sheep and Man....Pages 203-208 Vasopressin in Patients with Liver and Cardiac Disease....Pages 209-214 Reversal of Hyponatremia in Experimental Schwartz-Bartter Syndrome with a Vasopressin Antagonist (SK&F 101926)....Pages 215-217 The Vasopressin Antagonist SK&F 101926 is a Selective Aquaretic Agent in Dogs....Pages 218-221 Front Matter....Pages 223-223 The Antihypertensive Mechanism of Diuretics....Pages 225-230 Metabolic effects of Long-Term Diuretic Treatment....Pages 231-236 Antihypertensive Diuretics-Old and New....Pages 237-248 The Physiology of Natriuretic Mechanisms in the Kidney....Pages 249-260 Intracellular Electrolytes in Essential Hypertension during Treatment with Torasemide....Pages 261-264 The Isolated Perfused Rat Kidney as a Model for the Study of Diuretics in Hypertension....Pages 265-267 Antihypertensive Mechanisms of Muzolimine....Pages 268-270 Front Matter....Pages 223-223 Indapamide: Antihypertensive Activity and Renal Effects....Pages 271-273 In Vitro Effects of Furosemide on Rabbit Blood Vessels....Pages 274-276 Comparison of Torasemide and Indapamide in the Treatment of Essential Hypertension....Pages 277-279 Modifications in Cardiovascular Norepinephrine Responsiveness by Diuretic Treatment in Mild Renal Parenchymal Disease....Pages 280-282 Muzolimine Versus Captopril in Low and Mild Hypertension....Pages 283-285 The Hypotensive Action of Indapamide....Pages 286-288 Etozolin Induced Urine Excretion of Water and Solutes in Patients with Hypertension....Pages 289-291 Calcium Metabolism in Essential Hypertensive Patients Treated with Etozolin....Pages 292-294 Improvement in Exercise-Induced Diastolic Blood Pressure Changes by Diuretic Treatment....Pages 295-297 Antihypertensive Activity and Tolerability of Thiobutizide Alone or in Fixed Combination with Potassium Canrenoate in Essential Hypertension....Pages 298-300 K-Rich/Na-Poor Salt Reduces Blood Pressure in Hospitalized Patients....Pages 301-304 Combination of Nifedipine and Chlorthalidone in the Treatment of Hypertension....Pages 305-307 Cardiovascular Reflex and Systemic Hemodynamics Relationship in Patients with Essential Hypertension under Chronic Treatment with Indapamide....Pages 308-310 Comparison of Long Term Metabolic Effects of Muzolimine and Chlorthalidone in Patients with Arterial Hypertension....Pages 311-313 Etozolin in Hypertension with Renal Failure....Pages 314-316 Efficacy and Tolerability of Muzolimine in the Long-Term Treatment of Essential Hypertension....Pages 317-319 Muzolimine in the Treatment of Arterial Hypertension in the Elderly....Pages 320-322 Long-Term Therapy with Muzolimine in Patients with Mild to Moderate Essential Hypertension....Pages 323-325 Hemodynamic Changes in Patients with Essential Hypertension after Therapy with Muzolimine....Pages 326-329 Relaxing Action of Muzolimine on Guinea-Pig Isolated Aorta....Pages 330-332 Front Matter....Pages 333-333 The Cardiovascular Effects of Diuretics....Pages 335-343 Aspects of the Mechanism of Action of Diuretics in Heart Failure....Pages 344-349 Treatment of Chronic Nonhydropic Congestive Heart Failure: Effect of Hydrochlorothiazid and Triamteren on Cardiac Performance....Pages 350-352 Comparison of the Efficacy and Saftey of 5 Mg/ 10 Mg Torasemide (To) in Patients with Chronic Heart Failure....Pages 353-355 Influence on Water and Solutes Excretion Determined by Different Administrations of Muzolimine and Furosemide in Patients with Congestive Heart Failure....Pages 356-358 Evidence of Improvement in Myocardial Contractility After Acute Orally Muzolimine Administration....Pages 359-361 Intraindividual Comparison of Effects of Piretanide, Bumetanide and Furosemide in Congestive Heart Failure....Pages 362-364 Front Matter....Pages 365-365 Prevention of Acute Renal Failure (ARF) by Diuretics and Hydration....Pages 367-372 Comparison of Dose-Related Efficacy of Torasemide and Furosemide in Patients with Advanced Renal Failure....Pages 373-375 Pharmacodynamics and kinetics of torasemide and its metabolites in chronic renal failure after i.v. administration of 20 mg torasemide....Pages 376-378 Muzolimine in the Treatment of Acute Tubular Necrosis Following Renal Transplantation....Pages 379-381 Torasemide in chronic renal failure....Pages 382-384 Muzolimine vs Frusemide in Chronic Renal Failure: Short Term Effect in Double-Blind Study....Pages 385-387 Effects of Etozolin in Uremic Patients on Dialysis with Residual Renal Function....Pages 388-390 Can High-Dose Diuretic Therapy Reduce the Frequency of Hemodialytic Treatment?....Pages 391-393 Use of High Dose of Muzolimine in Acute Fluid Retention in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD)....Pages 394-396 Double Blind Cross-Over Comparison of Muzolimine and Placebo in Patients on Maintenance Hemodialysis....Pages 397-399 Effects of the Loop-Diuretic Muzolimine in Rats with HgCl 2 — Induced Acute Renal Failure (ARF)....Pages 400-402 Effects of Muzolimine on Experimental Acute Renal Failure (ARF)....Pages 403-405 Enhanced Recovery of Acute Renal Failure with Dopamine + Muzolimine....Pages 406-408 Front Matter....Pages 365-365 The Use of Muzolimine in Nephrotic Syndrome: Diuretic Effect and Tubular Functions....Pages 409-411 Favourable Effects of Muzolimine on Urea Plasma Levels in Chronic Renal Failure....Pages 412-414 Furosemide as an Agent Enhancing Peritoneal Dialysis Efficiency....Pages 415-417 Furosemide and Peritoneal Transport of Uric Acid - Experimental Studies....Pages 418-420 Front Matter....Pages 421-421 Comparison of Pharmacodynamics and Pharmacokinetics of Torasemide and Furodemide in Patients With Ascites Due to Cirrhosis of the Liver....Pages 423-425 Comparative Evaluation of Muzolimine and Furosemide in Healthy Subjects and in Liver Cirrhosis....Pages 426-428 Restoration of Response to Diuretics with Plasma Expanders and Aminophylline in Ascitic Cirrhosis of Liver....Pages 429-431 Behaviour of Red Blood Cell Potassium and of Other Hydro-Electrolyte Parameters During Spironalactone Treatment in Patients with Non Compensated Liver Cirrhosis....Pages 432-434 Muzolimine as Treatment of Ascites from Hepatic Chirrosis....Pages 435-437 Front Matter....Pages 439-439 Extrarenal Effects of Hydrochlorothiazide in Hypercalciuric Stone Formers....Pages 441-443 Causes of Failure in Thiazide Diuretic Therapy of Hypercalciuric Nephrolithiasis....Pages 444-446 Comparison of Two Different Association of Diuretics in Reducing Hypercalciuria in Recurrent Calcium Stone Formers....Pages 447-449 Medical Treatment of Idiopathic Calcium Nephrolithiasis: Thiazide (T) vs Stone Clinic Effect....Pages 450-452 Effect of Thiazide Diuretics on Hypercalciuria Induced by Active Vitamin D Metabolites....Pages 453-455 Front Matter....Pages 457-457 Captopril Protects Against Metabolic Effects of Chronic Hydrochlorothiazide Therapy....Pages 459-461 Gynecomastia and Mastodynia after Spironolactone and Potassium Canrenoate....Pages 462-464 Side Effects from Diuretics in Hospitalized Patients....Pages 465-467 Diuretic-Associated Hypokalemia: A Prevalent and Expensive Disease?....Pages 468-470 Effects of Muzolimine on Free-Water Excretion in Edematous and Hyponatremic Patients....Pages 471-473 Irreversible Hyponatremia Due to Incongruous Spironolactone Treatment....Pages 474-476 Front Matter....Pages 457-457 The Diuretic Effects of Lithium Salts. Absence of Side Effects....Pages 477-479 Renal Failure Due to Diuretics....Pages 480-482 The Effects of Spironolactone and Amiloride on Plasma Electrolytes in Thiazide Treated Subjects....Pages 483-485 Hemorheological Effects of Diuretics....Pages 486-488 Diuretic Effect and Electrolyte Changes Caused by Oral Peg 200 in Rat....Pages 489-493 Front Matter....Pages 495-495 Changes in Kinetics of Electrolyte Excretions Induced by Adding Triamterene to Thiazide....Pages 497-499 Beneficial Effects of Ibopamine in Idiopathic Edema....Pages 500-502 Kaliuresis Induced by Various Diuretics....Pages 503-505 Natriuretic Potency of Various Diuretics....Pages 506-508 Short Term Effects of Muzolimine on Electrolytes and Acid-Base Balance....Pages 509-511 Effects of Torasemide’s Metabolites on Water and Electrolyte Excretion in the Rat....Pages 512-514 Role of Central Gabaergic System on Rat Diuresis....Pages 515-517 Front Matter....Pages 519-519 Use of Diuretics to Investigate Renal Function....Pages 521-526 The Significance of the Macula Densa Mechanism for Renin Release....Pages 527-529 Furosemide I.V. Test to Check Distal Acidification. Normal Values in Adults....Pages 530-532 Tubular Function in Bartter’s Syndrome and Changes Induced by Chronic Converting Enzyme Blockade....Pages 533-535 Type II Pseudohypoaldosteronism: Differential Effects of Loop Diuretics and Hydrochlorothiazide....Pages 536-538 Clinical Evaluation of Proximal Tubule Na/Fluid Reabsorption:Lithium Clearance vs “Volume or Chloride Factors” During Maximal Water Diuresis and Furosemide Administration....Pages 539-541 Henle’s Loop (HL) Reabsorption Measured by Furosemide (F)....Pages 542-544 Front Matter....Pages 545-545 Effects of the New Uricosuric Diuretic Bay r 4420 on Rat Kidney Function....Pages 547-549 Front Matter....Pages 545-545 Characterization of the Renal and Hormonal Effects of Three Novel Anti-Mineralocorticoids in Vitro and in Vivo....Pages 550-552 Renal Effests of Etozolin in Man....Pages 553-555 Effects of Enalapril on Water and Salt Balance and Renal Hemodynamics....Pages 556-558 Front Matter....Pages 559-559 Effect of Indomethacin on the Saluretic Activity of Bumetanide....Pages 561-563 Role of Renal Prostaglandins in Mediating the Activity of Muzolimine in Man....Pages 564-566 Cicletanine - an Antyhypertensive Drug with a Powerful Natriuretic Effect; Role of Renal Prostaglandins....Pages 567-569 Effects of Muzolimine on Renal Prostaglandin Biosynthesis in Healthy Subjects....Pages 570-573 Effect of Muzolimine on Prostaglandin E 2 Synthesis and Catabolism in Rat Kidney....Pages 574-576 The need for adequate means by which to improve urine output is very old. Even in the "Scuola Salernitana", the oldest medieval medical school in Western Europe, about 1000 years ago it was taught how to improve urine output. The list of known "diuretica" included herbs, plants, roots, vegetables, in particular asparagus, fennel and carrot. The first diuretic drugs, however, were mercurial compounds. Thus, calomel, mercurous chloride, was initially used as a diuretic in the sixteenth century by Paracelsus, being one of the ingredients of the so-called "Guy's Hospital pill". But calomel had a cathartic effect so that it was replaced by organic mercurial compounds. These diuretics were clearly toxic. After the discovery of the carƯ bonic anhydrase, in the early 1930s, and the introduction of sulfanilamide as a chemotherapeutic agent, it was observed that this drug was inhibiting carbonic anhydrase in vitro and urinary acidification in vivo thereby causing metabolic acidosis; urine output, however, appeared to increase. Subsequent studies led to the synthesis of more potent analogs, in particular acetazolamide. Studies on carƯ bonic anhydrase inhibitors led to the synthesis of benzothiadiazides which disclosed much less inactivating action on carbonic anhydrase and much more diuretic effect through an inhibition of tubular transport of sodium and chloride. Chlorothiazide was the first member of this class of diuretics. Thiazides are still used in clinical practice