Activity of a new high efficiency diuretic in man: piretanide (HOE 118).

Abstract

1 The pharmacological actions of piretanide, a new high efficiency diuretic, were studied in sixteen patients with GFR (inulin clearance) varying from 0.1 -2.5 ml/s. 2 After hydration and following two control periods, a single dose of 6 mg piretanide was ingested. Thereafter, urine was collected every 30 min for 2 h and every hour for the next 4 h. Fluid losses were replaced. 3 The following measurements were made: urine flow rate, clearances of inulin, PAH, urea, creatinine, uric acid, osmolar and free water clearances, excretion rates of sodium, chloride, potassium, calcium, phosphate, bicarbonate, ammonium, titratable acidity and urine pH. 4 Main results showed piretanide was efficient in the group with normal GFR (inulin clearance > 1.5 ml/s) and in the group with slightly decreased GFR (1.0 < inulin clearance < 1.4 ml/s), in terms of diuresis, natriuresis, kaliuresis and calciuresis. It was inefficient in the group with severe renal insufficiency (inulin clearance < 0.3 ml/s). 5Free water clearance showed preservation of diluting ability to a large extent. 6 In the three groups, no significant change in inulin clearance and PAH clearance occurred.

Piretanide and Urinary Excretion of Ions in Rat. Effect of Indomethacin

“…Like frusemide, piretanide increased urinary excretion of chloride, potassium and calcium, This effect was greater on chloride than on sodium, as has previously been shown in man by Pozet et al (1980). This can 6e explained by the fact that piretanide inhibits chloride reabsorption in the ascending limb of Henle's loop (Zeuthen et al, 1978).…”

The effects of a combination of piretanide and triamterene in healthy subjects.

“…In man, piretanide 6 mg and frusemide 40 mg orally are approximately equipotent (Roberts, Homeida, Roberts & Bogie, 1978). In patients with cardiac failure 9 mg piretanide produces a similar diuresis to 1 mg bumetanide (Homeida, Roberts & Dombey, 1979) and piretanide has been shown to be an effective diuretic in renal insufficiency (Pozet, Hadj-Aissa, Pellet & Traeger, 1980). Piretanide has a duration of action of about 6 h (Lawrence, Ansari, Elliot, Sumner, Brunton, Whiting & Whitesmith, 1978).…”

Separate Calculation of Glomerular and Tubular Clearance by Means of Renal Scintigraphy with Hippuran and DTPA

“…Measurement o f glomerular filtration by inuiin clearance (Q n) and renal plasma flow by PAH clearance (CPAH) is obtained by continuous infusion o f these substances and collection of urine by a method that has been described previously [5]. Normal values in our laboratory are I2 0 ± 3 0 and 650 +: 165 ml/min/1.73 m2, respectively, for Cin and CPAH.…”