Diuretika

Diuretika are medications that increase urine production by promoting the excretion of water and electrolytes. They are used to treat edema related to heart failure, liver cirrhosis, and kidney disease, as well as hypertension and certain fluid-imbalance conditions. By reducing fluid overload, they help relieve symptoms and can improve organ function, though they do not cure the underlying disease.

Diuretics are classified by where they act in the nephron and by their primary mechanism. Thiazide diuretics inhibit the Na-Cl cotransporter in the distal convoluted tubule, providing moderate diuresis and strong antihypertensive effects. Loop diuretics block the Na-K-2Cl cotransporter in the thick ascending limb and produce potent diuresis, useful for significant edema or renal impairment but with higher risk of electrolyte loss. Potassium-sparing diuretics include aldosterone antagonists such as spironolactone and eplerenone, and sodium channel blockers like amiloride and triamterene; they reduce potassium loss and are often used with other diuretics. Osmotic diuretics such as mannitol increase plasma osmolarity to draw water into the filtrate and are used in acute settings such as cerebral edema. Carbonic anhydrase inhibitors like acetazolamide cause bicarbonate diuresis and have niche uses (glaucoma, altitude sickness) with relatively weaker diuretic potency.

Safety and monitoring: diuretics require regular monitoring of electrolytes, renal function, and blood pressure. Common adverse effects include dehydration and electrolyte disturbances (hyponatremia or hypokalemia with thiazides/loops; hyperkalemia with potassium-sparing agents), metabolic alkalosis, and potential interactions with NSAIDs or other antihypertensives that can affect efficacy.