Clinical Effect and Mechanism of a New Diuretic: Piretanide

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In order to clarify the mechanism of piretanide (PN), a new saluretic developed by Hoechst AG., PN 6 mg was intravenously injected to patients having at least 70 % of normal renal function and to healthy subjects as controls under the condi tions of water load and water restriction. The following results were obtained by the renal clearance test: 1) Urine volumes markedly increased after PN administration. Peak diuresis was obtained 30 minutes following injection. 2) PN is considered to act on the diluting segment of the ascending loop of Henle, basing on the fact that CH2O decreased under water load, whereas TCH2Odecreased under water restriction. 3) Urinary excretion of electrolytes increased following PN administration. The excretion of Na, Cl, K, and Ca, was particularly predominant. 4) Urine pH tended to decrease following PN administration. This loss of H+into the urine may potentially cause alkalosis of body fluids.
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