Research Article| Volume 76, ISSUE 2, P280-292, August 1970

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Renal mechanisms of the natriuretic and antiphosphaturic effects of triflocin—a new diuretic

  • Zalman S. Agus
    From the Renal Section, Department of Medicine, University of Pennsylvania, School of Medicine Philadelphia, Pa., USA
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  • Martin Goldberg
    Reprint requests: Martin Goldberg, M.D., 860 Gates Building, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, Pa. 19104.
    From the Renal Section, Department of Medicine, University of Pennsylvania, School of Medicine Philadelphia, Pa., USA
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  • Author Footnotes
    ∗ Dr. Agus was a Postdoctoral Fellow supported by United States Public Health Grant No. 1 F3AM-38,709 from July 1968 to June 1969.
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      Acute clearance studies were performed in normal volunteers to determine the renal sites and mechanism of action of triflocin, a structurally new diuretic. The drug was found to be a moderately to markedly potent natriuretic agent, producing a maximal fractional sodium excretion which varied between 0.04 and 0.12. The natriuresis was associated with both an inhibition in free water clearance (CH2O) during sustained water diuresis and a reduction in solute-free water reabsorption (TcH2O) when superimposed upon a hypertonic saline diuresis during hydropenia, indicating a major site of action in the ascending limb of the loop of Henle. In addition, triflocin was found to produce a fall in glomerular filtration rate (10 to 15 per cent), unrelated to volume depletion, and a consistent but variable decrease in fractional phosphate excretion. The enhanced tubular phosphate reabsorption, an effect not previously described with other diuretics, is felt to be mediated by enhanced reabsorption of sodium in the proximal tubule, either by direct tubular action or via hemodynamic changes.
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