Why furosemide cant be used for treatment of Nephrogenic DI just like thiazides?

[tarsuc]

Rx of nephrogenic diabetes insipidus.

i understood the concept of thiazides being used. But wondering why furosemides cant work the same way in causing volume contraction leading to increase reabsorption at the PCT?

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[tasar1898]

It prolly has to with the strength of the diuresis.. with loops you lose like 2-3 times more sodium than with thiazides , so the PCT can't overcome that ... Imagine taking your thiazide , losing like 100mg of sodium , then your PCT reabsorbs 250 , for a net gain of 150mg . With the loop , you ll lose like 500mg so even if your PCT reabsorbs more due to volume contraction , you still have a net loss of 250mg . And with sodium , there goes the water and you urinate more--> worsen the DI. It's all a numbers game.. ( But the numbers here are completely arbitrary , just to drive the concept home )