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Pharmacokinetics and pharmacodynamics of diuretic action.

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1 Pharmacokinetics and pharmacodynamics of diuretic action.
Pharmacokinetics and pharmacodynamics of diuretic action. (A) Effects of CKD on diuretic actions. Note that in CKD, baseline fractional sodium excretion is high, to maintain absolute rates of sodium excretion equal to intake. There is a shift in the dose-response curve to the right (R), primarily owing to impaired diuretic secretion, but no change in the ceiling effect. (B) The same relationship plotted versus absolute rates of sodium excretion. The same rightward shift is evident, but the ceiling is lower, owing to the GFR reduction (as indicated by D). (C) Comparing effects of loop diuretics and distal convoluted tubule (DCT) diuretics on absolute sodium excretion, given a retained effect on fractional excretion. David H. Ellison CJASN doi: /CJN ©2019 by American Society of Nephrology

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