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Mechanism of action of diuretics

D Craig Brater, MD
Section Editors
Richard H Sterns, MD
Michael Emmett, MD
Deputy Editor
John P Forman, MD, MSc


Diuretics are among the most commonly used drugs. They act by diminishing sodium reabsorption at different sites in the nephron, thereby increasing urinary sodium and water losses. The ability to induce negative fluid balance has made diuretics useful in the treatment of a variety of conditions, particularly edematous states and hypertension.

A review of the mechanism and time course of action of diuretics will be presented here. Diuretic dosing and adverse effects are discussed separately. (See "Loop diuretics: Maximum effective dose and major side effects" and "Time course of loop and thiazide diuretic-induced electrolyte complications".)


The diuretics are generally divided into four major classes, which are distinguished by the site at which they impair sodium reabsorption [1,2]:

Loop diuretics act in the thick ascending limb of the loop of Henle

Thiazide-type diuretics in the distal tubule and connecting segment (and perhaps the early cortical collecting tubule)

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Literature review current through: Nov 2017. | This topic last updated: Jun 05, 2017.
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