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Mode of Action of Ethacrynic Acid in Congestive Heart Failure

George A. Porter, MD; William H. Bennett, MD; Herbert E. Griswold, MD
Arch Intern Med. 1968;121(3):235-242. doi:10.1001/archinte.1968.03640030027004.
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The renal response to a single intravenous dose of ethacrynic acid was evaluated in ten patients with cardiac decompensation. Following infusion of the drug, a prompt increase in urine flow occurred lasting for approximately two hours. During this diuresis, renal function studies disclosed a fall in tubular reabsorption of water, sodium and chloride, and an increase in osmolar clearance. These findings are compatible with a blockade of coupled sodium chloride reabsorption in either the ascending loop of Henle or early distal tubule or both, but do not exclude a redistribution of intrarenal blood flow as contributing significantly to ethacrynic acid's mode of action. Distal tubular exchange between sodium and potassium-hydrogen does not seem to be affected by this diuretic.


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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