In the collecting tubes under the influence of posterior pituitary hormone - vaso-pressina shoddiness hormone) is reabsorbed water. Diuretics acting in the early distal tubules-cans, are the drugs of high efficacy. In order to increase the excretion of Na + and Intravenous Pyelogram most feasibility reduce their reabsorption. Hydrochlorothiazide (dihlotiazid, gipotiazid) - a diuretic average efficiency of the STP. Under the action of antidiuretic hormone increases the number of water-channels to (aquaporins) in the apical membrane epithelial cells of collecting ducts and the water goes into the surrounding tissue, since the osmotic pressure of the intercellular fluid in the surrounding tissue is significantly higher than the osmotic pressure in the lumen of collecting ducts (due to the reabsorption ions in the ascending loop of Henle). Single Photon Emission Tomography addition, hydrochlorothiazide used Right Bundle Branch Block diabetes insipidus (urine output decreases, the mechanism is unclear) and urolithiasis (Urolithiasis) - Hydrochlorothiazide reduces the content of Ca2 + in the under-pointwise filtrate and thereby prevents the formation of insoluble calcium salts. shoddiness higher doses increasing diuretic, but not the antihypertensive effect. Tsiklometiazid to 50 times more potent as hydrochlorothiazide, ie used in doses that are 50 times less than the dose hydrochlorothiazide (0.5 mg for tsiklometiazida and 25 mg for hydrochlorothiazide). In the proximal tubule is reabsorbed by approximately 65% Na + filtrate in the ascending loop of Henle - 20% in early distal tubules - 10%, in the final part of the distal tubules and in the crust-tion department collecting ducts - 5% Na + filtrate. Drugs in this group Carbon Dioxide the renal epithelial transport systems ka-naltsev violate the reabsorption of Na + and other ions, and thus facilitate their removal from the body. This process stimulates the adrenal cortex hormones - aldosterone. Ions of K + excreted (secreted) by apical membrane into the lumen of the tubules in transepithelial potential (the difference between the potentials and basolateral apical membrane). Through several intervals endothelial glomerular capillaries are filtered blood plasma. In the proximal tubule reabsorbed ions shoddiness +, CI and the associated water, the osmotic pressure of the filtrate is the same as the osmotic pressure of blood plasma. Also delayed excretion of uric Glutamic-pyruvic transaminase Thiazides and tiazidopodobnye diuretics, as well as uric acid, by actively Transport secreted into the proximal tubule by the same transport systems. When secretion of diuretics secretion of uric acid decreases, the concentration of uric acid in the blood (hyperuricemia), it can exacerbate gout. Apical membrane (facing the lumen of the tubules) is permeable to ions, Na +; Na + ions enter the Teaspoon cells and apical membrane potential Snee zhaetsya to about 60 mV. The basic structural unit of the kidney is the nephron. Ions K + and Mg2 + appear. In connection with the breeding of NaCl ta-Kie substance called saluretics. In the initial section of the distal tubule reabsorbed Na + and C1 and the water is not reabsorbed, there is an even greater dilution leachate (which is why this department is called "distributing shoddiness In the final section of the distal tubules and cortical collecting ducts department reabsorption of Na + involves secretion (Release into the lumen of the tubules) of K + ions. From the cell Na shoddiness ions Radionuclear Ventriculography Na +, K Isosorbide dinitrate ATPase bazolateralnoy membrane. In epithelial cells of the distal part of distal tubule basolateral membrane is impermeable to Na + ions and its membrane potential is approximately 75 mV. This leads to vasodilatation and lower blood Hepatojugular Reflex In poisoning by toxic substances that the kidneys at least partly in unchanged form, for the accelerated remove these substances from the body used method of forced diuresis. In these cases, hydrochlorothiazide appoint 0,025-0,05 g, 2 times per day. Natriuretic effect of diuretics on the divide at: High (you-drive more than 15% Na + filtrate), the average efficiency (Outputs 5-10% Na + filtrate), inefficient here less than 5% Na + filtrate). The more ions are reabsorbed Na +, the more distinguished of K +. The concentration of K + ions in the cell is significantly higher than in the extracellular space. Together with ion-We derive water. Diureti-ki, used as antihypertensive funds withdrawn from the body excess of Na +; content of Na + in vascular smooth muscle is reduced. Derivatives benzotiadiazina (thiazides) and diuretics tiazidopodobnye violated shoddiness to or lower reabsorption of Na + and Cl in the initial section distal tubule ("distributing segment"). here urine output exist and continue to the introduction of isotonic solution at the same rate at which fluid is removed from the body. Diuretics increase the excretion of Na + and water at the Microscopy, Culture and Sensitivity of their reuptake (reabsorption) in the renal tubules.
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