Published in Volume
54, Issue 3 (September 1974)
J Clin Invest. 1974;54(3):628–637.
doi:10.1172/JCI107800.
Copyright ©
1974, The American Society for
Clinical Investigation.
Articles
On the Hypocalciuric Action of Chlorothiazide
Linda S. Costanzo and I. M. Weiner
1Department of Pharmacology, State University of New York, Upstate Medical Center, Syracuse, New York 13210
Published September 1974
Clearance experiments were performed in female mongrel dogs, either intact or thyro-parathy-roidectomized (T-PTX), under pentobarbital anesthesia, to examine the unusual hypocalciuric property of thiazide diuretics. The relationship between calcium clearance (CCa) and sodium clearance (CNa) was determined in normal dogs, CCa = 0.79 CNa; constant infusion of chlorothiazide (CTZ) to provide drug concentrations in plasma of approximately 40 μg/ml modified this relationship; CCa = 0.30 CNa (P < 0.001). The magnitude of the dissociating effect of CTZ on the urinary Ca/Na relationship was found to be most highly correlated with urinary drug concentration. Infusion of CTZ (1 mg/min) into one renal artery caused a unilateral decrease (25%) in CCa/GFR while producing a unilateral increase (80%) in CNa/GFR. The same dose of CTZ in T-PTX dogs produced an increase in CNa/GFR without causing a change in CCa/GFR. The defective response in T-PTX dogs could be ascribed to poor tubular secretion of the drug; when urinary drug concentrations were elevated in T-PTX dogs to the levels found in intact dogs (by infusing more drug), CCa/GFR fell to an equivalent extent. T-PTX dogs showed substantially lower renal extraction of CTZ (42%) than intact dogs (57%); PTH administration to T-PTX dogs increased extraction toward normal (49%). The defective secretion of CTZ could not be attributed to either a decreased tubular maximum or a decreased renal blood flow.
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