Therapeutic Uses Of Diuretic Agents
Vijay B. Arumugham, Mohamed H. Shahin
Abstract
Water constitutes about 60% of the average adult body weight and is responsible for many physiological processes in the human body. Thus, fluid and electrolyte homeostasis is critical for human survival as exemplified by the potentially devastating consequences of fluid imbalance. The balance of total body fluid is an extremely well-regulated process which ensures the maintenance of a balance between fluid gain and loss through different physiological mechanisms such as neural regulation of thirst, hormonal regulation (vasopressin and natriuretic peptides), management through the skin, hemodynamic changes, and renal control of salt and water excretion. In particular, renal excretion of urine also ensures the elimination of products of metabolic activity and excess electrolytes in addition to water, thus maintaining fluid homeostasis. Fluid balance so inextricably links with electrolyte balance both in the intracellular (rich in K+ ions) and extracellular (rich in Na+ & Cl- ions) compartments, that unsurprisingly, trading of electrolytes is the core strategy of renal fluid regulation. Drugs that affect renal regulation of electrolyte excretion have the greatest effect in terms of the quantity of fluid control and thus water homeostasis.