why give diuretics to Nephrogenic DI patients?

[MissMedicine]

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It seems like they're already losing a lot of fluids as it is?? 😕

 

[daisygirl]

*I think* you give them thiazide diuretics b/c by doing so it increases water reabsorption in the proximal tubule- so you actually help them retain some water vs just wasting it away. You wouldn't give them loop diuretics since they are too powerful. I'm nowhere close to my renal studying so I may be way off here

 

[daisygirl]

Copied and pasted from my notes service....

....it has been determined that the beneficial effect is mediated through plasma volume reduction with an attendant fall in GFR, enhanced proximal reabsorption of NaCl and water and decreased delivery of fluid to the diluting segments. Thus, the maximum volume of DILUTE urine that can be produced is lowered. This seemingly paradoxical effect of thiazides can significantly reduce urine flow in the polyuric patient.

 

[MissMedicine]

ahhh, thanks daisy...makes sense 😉 you de best!