Diuretics: a contemporary pharmacological classification?

Kehrenberg, Miriam C A; Bachmann, Hagen S.

doi:10.1007/s00210-022-02228-0

Cited by 22 publications

(17 citation statements)

References 48 publications

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Section: Introductionmentioning

confidence: 99%

“…Diuresis is one of the main physiological processes involved in fluids homeostasis, its modulation being also linked with the management of several human pathologies, including hypertension, heart failure, urinary tract or hepatic disorders and poisonings (Zeng et al, 2019;Suri and Pamboukian, 2021;Zaccherini et al, 2021;Curtain et al, 2022;Kehrenberg and Bachmann, 2022;Zhou et al, 2022). Pharmacological evidence support the use of diuretics as valuable therapeutic agents in modern medicine, their pharmacodynamic and pharmacotoxicologic mechanisms being well-documented and, at the same time, carefully analyzed before the initiation of therapy (Titko et al, 2020;Kehrenberg and Bachmann, 2022). However, long-term use of some diuretics, especially in chronic diseases, is associated with several side-effects (i.e., hydroelectrolytic or hormonal imbalances, kidney injuries and hyperglycaemia) (Titko et al, 2020;Kehrenberg and Bachmann, 2022;Zhou et al, 2022), encouraging the development and use of alternative diuretic agents from natural sources, including phytomedicines.…”

Section: Introductionmentioning

confidence: 99%

“…Pharmacological evidence support the use of diuretics as valuable therapeutic agents in modern medicine, their pharmacodynamic and pharmacotoxicologic mechanisms being well-documented and, at the same time, carefully analyzed before the initiation of therapy (Titko et al, 2020;Kehrenberg and Bachmann, 2022). However, long-term use of some diuretics, especially in chronic diseases, is associated with several side-effects (i.e., hydroelectrolytic or hormonal imbalances, kidney injuries and hyperglycaemia) (Titko et al, 2020;Kehrenberg and Bachmann, 2022;Zhou et al, 2022), encouraging the development and use of alternative diuretic agents from natural sources, including phytomedicines.…”

Section: Introductionmentioning

confidence: 99%

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Phenolic profile, in vitro antimicrobial and in vivo diuretic effects of endemic wild thyme Thymus comosus Heuff ex. Griseb. (Lamiaceae) from Romania

et al. 2023

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Thymus comosus Heuff ex. Griseb. (Lamiaceae) is a wild thyme species endemic for Romanian Carpathian areas, frequently collected as substitute for collective herbal product Serpylli herba, cited as antibacterial and diuretic remedy in traditional medicine. The present study aimed to evaluate the in vivo diuretic effect and in vitro antimicrobial properties of three herbal preparations (infusion—TCI, tincture—TCT and an hydroethanolic extract prepared through an optimized ultrasound-assisted method—OpTC) obtained from the aerial parts of T. comosus Heuff ex. Griseb, also evaluating their comprehensive phenolic profile. In vivo diuretic effect was tested using Wistar rats treated orally with each herbal preparation (125 and 250 mg/kg dispersed in 25 ml/kg isotonic saline solution) and quantified based on cumulative urine output (ml), diuretic action and diuretic activity. Additionally, sodium and potassium excretion were monitored using a potentiometric method with selective electrodes. In vitro antibacterial and antifungal activities were assessed using p-iodonitrotetrazolium chloride assay against six bacterial strains and six fungal strains by monitoring minimum inhibitory concentration (MICs), minimum bactericidal concentrations (MBCs) and minimum fungicidal concentrations (MFCs). Finally, phenolic profile of the aforementioned herbal extracts was evaluated using an ultra-high-pressure liquid chromatography (UHPLC) coupled with high-resolution mass spectrometry (HRMS) method to check the impact of the different preparations on the most abundant and significant compounds. All the extracts exerted a mild diuretic action, TCT and OpTC inducing the most intense diuretic effect. Both herbal preparations produced a statistically significant, dose-dependent and gradual increase of the urine output, the effect being more intense at 24 h (6.63–7.13 ml/24 h). Potentiometric evaluation of urine samples collected from treated rats revealed a clear and mild natriuretic and kaliuretic effect after the administration. In terms of antimicrobial activity, E. coli (MIC—0.38 mg/ml), B. cereus (MIC—0.75 mg/ml)), Penicillium funiculosum and P. verrucosum var. cyclopium (MIC—0.19 mg/ml) showed the greater sensitivity to the tested extracts, respectively. UHPLC-HRMS screening showed that the bioactive potential of T. comosus herbal preparations was likely related to the higher amounts of phenolic acids (including rosmarinic acid), flavonoids (mainly flavones and derivatives) and other phenolics (such as different isomers of salvianolic acids) in their composition. The obtained results support the ethnopharmacological evidence regarding the mild diuretic and antibacterial potentials of the endemic wild thyme T. comosus, this study being the first one that assessed the aforementioned bioactivities for this species.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Phenolic profile, in vitro antimicrobial and in vivo diuretic effects of endemic wild thyme Thymus comosus Heuff ex. Griseb. (Lamiaceae) from Romania

et al. 2023

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“…Diuretics are drugs which enhance urine flow by causing the kidneys to remove electrolytes and water from the body. (1) They are among the most commonly prescribed medications, and are used to establish a negative fluid and salt balance in a number of clinical disorders. (2) However, their use has been attributed to a range of problems that are predicted given their modes of action, including hypokalemia, hyponatraemia, metabolic acidosis, glucose intolerance, and hypomagnesaemia.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Diuretic Activities of 80% Methanol Leaf Extract and Solvent Fractions ofRumex nepalensisin Mice

Tafesse,

Asrie,

Belete

2023

Preprint

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BackgroundThe leaf ofRumex nepalensishas historically been employed to treat urinary retention and as a diuretic. Despite these assertions, there has been very little research addressing the diuretic effect of the leaves ofR. nepalensis. Therefore, this study was done to examine the diuretic properties of R. nepalensis leaves.MethodsCold maceration with 80% methanol was used to extract the coarsely powdered leaves ofR. nepalensis. The extract was separated using increasing polarity solvents, beginning with n-hexane, ethyl acetate, and water. Mice were split into sections to test the plant’s diuretic properties. The negative control groups were given either distilled water or 2% tween 80; the positive control groups were given furosemide (10 mg/kg); and the test groups were given the 80% methanol extract and solvent fractions orally at dosages of 100, 200, and 400 mg/kg. The urine volume was determined, and urine analysis was performed on each extract.ResultsAt dosage levels of 200 mg/kg and 400 mg/kg, the 80% methanol extract, ethyl acetate fraction, and aqueous fraction all produced substantial diuresis (p<0.001) as compared to the negative control. Similarly, mice given the 80% methanol extract, ethyl acetate fraction, and aqueous fraction demonstrated substantial natriuresis (p<0.001) and kaliuresis (p<0.001) at dosages of 200 mg/kg and 400 mg/kg, respectively, in comparison to the negative control.ConclusionThe diuretic activity ofR. nepalensiswas significantly seen in the 80% methanol extract, ethyl acetate, and aqueous fractions, which corroborated the plant’s traditional use.

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“…7 Diuretics are drugs that can increase urine production due to the excretion of water and electrolytes by the kidneys. 10,11 The accumulation of fluid in the body's tissues is due to the inability of the kidneys to release sodium and water which are excreted together. Diuretics can be used to treat edema, heart failuure, and hypertension.…”

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confidence: 99%

Diuretic Potency of Belalai Gajah Plants (Clinacanthus nutans (Burm.fil.) Lindau)

Panjaitan¹,

Afandi²,

Aprilia³

2023

Pharmacogn J.

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Hypertension is a major risk factor for cardiovascular disease and chronic kidney disease, the leading cause of death globally. 1 Hypertension or high blood pressure is a condition where after two separate measurements there is an increase in systolic blood pressure ≥140 mmHg and/or diastolic ≥90 mmHg. [2][3][4] If left unchecked, this disease can interfere with the function of other organs such as the heart and kidneys which are vital organs. 5 Symptoms that can be caused in people with hypertension are chest pain, vision problems, ringing in the ears, fatigue, confusion, headache, feeling of heaviness in the back of the neck, vertigo, nosebleeds, dyspnea/ shortness of breath, increased frequency of urine, nausea, sleep apnea, irregular heartbeat regular. 6,7 Factors that cause hypertension are age, family history, being overweight/obese, not being physically active, using tobacco, consuming too much salt (sodium) in the food consumed, too little potassium in the food consumed, consuming too much alcohol. 8 Hypertension often occurs in patients with chronic kidney disease. Hypertension management is needed to control blood pressure and prevent complications. Prevention of hypertension can be done with non-pharmacological efforts such as weight loss and limiting salt intake. As for pharmacological treatment such as therapy with antihypertensive drugs, one of which is diuretics. 7 Diuretics are drugs that can increase urine production due to the excretion of water and electrolytes by the kidneys. 10,11 The accumulation of fluid in the body's tissues is due to the inability of the kidneys to release sodium and water which are excreted together. Diuretics can be used to treat edema, heart failuure, and hypertension. 11 Diuretics can be categorized into three groups: loop diuretics, thiazide diuretics, and potassium-sparing diuretics. [12][13][14] Diuretics are used to improve the composition and volume of fluids in the body, which treats hypertension. 15,16 The mechanism of action of diuretic drugs in lowering blood pressure is by helping the kidneys function in filtering, removing salt and water, which in turn reduces the volume of fluids in the body so that blood pressure also decreases. 7,17 Hypertension is generally treated using synthetic drugs such as furosemide. [18][19][20][21] Furosemide is a loop diuretic that can reduce the reabsorption of sodium produced by the kidneys. Furosemide can inhibit the luminal Na-K-Cl co-transporter in the loop of Henle by binding to the chloride transport channel. In this case, elevated levels of Na, Cl, and K remain in the urine. 22 Long-term use of furosemide is known to cause electrolyte balance disturbances (excessive loss of sodium and potassium),

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Diuretics: a contemporary pharmacological classification?

Cited by 22 publications

References 48 publications

Phenolic profile, in vitro antimicrobial and in vivo diuretic effects of endemic wild thyme Thymus comosus Heuff ex. Griseb. (Lamiaceae) from Romania

Phenolic profile, in vitro antimicrobial and in vivo diuretic effects of endemic wild thyme Thymus comosus Heuff ex. Griseb. (Lamiaceae) from Romania

Evaluation of the Diuretic Activities of 80% Methanol Leaf Extract and Solvent Fractions ofRumex nepalensisin Mice

Diuretic Potency of Belalai Gajah Plants (Clinacanthus nutans (Burm.fil.) Lindau)

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