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Kaplan Qbank USMLE



Author3 Posts
  #1

Can anyone explain how thiazide diuretics treat nephrogenic diabetes insipidus...its not very clear to me.


  #2

ok this is what i understood...diuretics decrease extracellular fluid volume and so promote proximal tubular absorption which is not dependent on ADH.The result is less free water transmitted to distal collecting tubules where the urine concentrating defect is located ...n therefore less polyuria.

am i right buddies?confused


  #3

In a Sense u r right. the Exact Mech is that Thiazides hinder the NaCl tranpsort in the DCT which leads to Sodium loss in the urine which has a result of INCREASED Na and Water Reabsorption in the Proximal Tubules. thus leading to dec load of Salt and Water to the Effected area to upon. Nephrogenic DI is characterised by ADH resistence i.e there is little effect of ADH, thus if u dec the load presented the deficit is relatively small and can be easily overcome by whtever little effect of ADH remains.


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