How does thiazides help diabetes insipidus?
How does thiazides help diabetes insipidus?
Abstract. Thiazides have been used in patients with nephrogenic diabetes insipidus (NDI) to decrease urine volume, but the mechanism by which it produces the paradoxic antidiuretic effect remains unclear.
Do thiazide diuretics cause diabetes insipidus?
The clinical use of thiazides in nephrogenic diabetes insipidus. Drugs are the most important causes of NDI [3]. This condition is characterized by unresponsiveness of the kidney to the action of vasopressin.
Can hydrochlorothiazide cause diabetes insipidus?
Antidiuretic Effect of Hydrochlorothiazide in Lithium-Induced Nephrogenic Diabetes Insipidus Is Associated with Upregulation of Aquaporin-2, Na-Cl Co-transporter, and Epithelial Sodium Channel.
Which diuretic is used for nephrogenic diabetes insipidus?
Nephrogenic diabetes insipidus. Treatment with the drug hydrochlorothiazide (Microzide) may improve your symptoms. Although hydrochlorothiazide is a type of drug that usually increases urine output (diuretic), it can reduce urine output for some people with nephrogenic diabetes insipidus.
Why do we give diuretics to diabetes insipidus?
If you have more severe nephrogenic diabetes insipidus, you may be prescribed a combination of thiazide diuretics and a non-steroidal anti-inflammatory drug (NSAID) to help reduce the amount of urine your kidneys produce.
What is the mechanism of action of thiazide diuretics?
The MOA of thiazide diuretics is to decrease sodium reabsorption and therefore decreased fluid reabsorption; this directly causes decreased levels of circulating sodium.
Are thiazides contraindicated in diabetes?
Prolonged thiazide diuretic therapy can lead to glucose intolerance and may occasionally precipitate diabetes mellitus. Short-term metabolic studies, epidemiologic studies, and a variety of clinical trials suggest a connection between ongoing thiazide diuretic use and the development of type 2 diabetes.
Why does HCTZ treat nephrogenic diabetes insipidus?
Experiments by Kim et al. suggest that thiazides may serve to upregulate aquaporin channels and ENaC subunits. In rates with lithium-induced nephrogenic DI, HCTZ reversed lithium-induced downregulation of AQP2. It also caused an increase in the abundance of ENaC channels.
Why do you use diuretics in diabetes insipidus?
Why is amiloride used for diabetes insipidus?
Amiloride has been proposed as an alternative for those patients who develop lithium-induced nephrogenic diabetes insipidus in whom drug suspension is not the best option. This drug prevents the entry of lithium to the nephron by blocking the epithelial sodium channel (ENaC) in the main cells.
What is a major side effect of thiazide diuretic?
Thiazide diuretics are sulfa-containing drugs. Patients with sulfa allergies taking thiazides may experience headaches, rash, hives, swelling of the mouth and lips, wheezing or trouble breathing, asthma attack, and anaphylaxis.
Why do thiazides cause hyperglycemia?
In addition, thiazide diuretics are postulated to down-regulate peroxisome proliferator-activated receptor gamma, thereby decreasing insulin release in addition to activating the reninangiotensin-aldosterone system, thus resulting in elevated levels of aldosterone and resulting hyperglycemia.
Why are thiazides diuretics contraindicated in diabetes?
Can diabetics take thiazide diuretics?
The recommendations of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7)1 and the American Diabetes Association (ADA)2 advocate the use of thiazide diuretics (usually in addition to an angiotensin-converting enzyme [ACE] inhibitor) in patients who have …
Why do we give diuretics in nephrogenic diabetes insipidus?
Which drug is used in lithium-induced diabetes insipidus?
Vasopressin, amiloride and thiazide diuretics have been used in lithium-induced nephrogenic diabetes insipidus treatment. Acetazolamide might be an option to treat lithium-induced nephrogenic diabetes insipidus patients who fail to respond to standard treatment.
Why indomethacin is used in nephrogenic diabetes insipidus?
To the Editor: In patients with lithium-induced nephrogenic diabetes insipidus, indomethacin has been reported to decrease urinary output and raise urinary osmolality. Indomethacin is an inhibitor of prostaglandin synthesis in the kidney.
What is the most important adverse effect of loop and thiazide diuretics?
Most widely recognized, the first adverse effect of thiazide diuretics is hypokalemia. As discussed above, hypokalemia is a sequela of the aldosterone-mediated actions of the Na/K pump in the CT. Hypokalemia can be life-threatening and requires monitored during the first 2-3 weeks of HCTZ therapy. Hyponatremia.
Why thiazides are contraindicated in diabetes?
How do thiazides cause hypoglycemia?
One prevailing theory is that thiazide-induced potassium depletion is responsible for decreased insulin secretion and/or reduced insulin sensitivity, leading to impaired glucose tolerance and hyperglycemia.