Diuretics have been one of the most powerful pharmacologic tools developed to be used by the clinician in the treatment of patients. The mechanisms and sites of action of the various diuretics have been studied with multiple experimental techniques. With the use of these diuretic agents and experimental techniques, we have not only understood the mechanism of the action of diuretics, but, in addition, these studies have made a major contribution to our understanding of normal renal physiology. This article will review the concepts of the tubular actions of diuretics and their use and abuse.
Slightly more than two decades ago, there was little choice of a diuretic agent that could be used in the treatment of a patient. Today, there are a large number of agents that alter the reabsorption of electrolytes by the renal tubules. These agents, however, vary greatly in their mechanism and site of action and