Diuretics refer to active substances that significantly increase the excretion of salts as well as water by the kidney from the body (human and animal). Therefore, they are used in the therapy of numerous diseases such as hypertension, glaucoma and edema.
What are diuretics?
Herbal diuretics, such as horsetail, also promote the flushing of salts and water out of the body by the kidneys. Diuretics reduce plasma volume in the bloodstream and relieve congestion symptoms, such as fluid accumulation in tissues or excessive blood volume. Some diuretics, such as acetazolamide, help to make urine more alkaline, thus promoting the excretion of substances such as aspirin in the event of overdose or poisoning. Diuretics are divided into three main typical groups: Thiazides, loop diuretics, and potassium-sparing diuretics. Each exerts its effect by acting on a different part of the kidneys and requires different applications as well as precautions, must therefore be carefully matched to the state of health. In this context, the antihypertensive effect of some diuretics should also be considered independently of their diuretic effect.
Application, effect, and use
Loop diuretics increase renal blood flow and therefore flush out up to 20% of the sodium chloride dissolved in water. Normally, about 0.4% sodium is excreted in the urine. Loop diuretics such as furosemide inhibit the body’s ability to absorb sodium, so less water is excreted in the urine and remains in the body’s cells. They are used to treat ascites and edema due to heart failure or cirrhosis of the liver or kidney disease. Thiazide diuretics also increase urinary excretion of sodium. The short-term blood pressure-lowering effect is due to the fact that thiazides lower cell tension. In the long term, thiazides have a vasodilatory effect. Physicians therefore recommend them as the first drug for treating high blood pressure as well as heart problems associated with hypertension. Only when diuretics alone are not sufficient are drugs such as beta-blockers usually used. The term potassium-sparing diuretics refers to the reduction of sodium uptake in the tubular epithelial cells, thereby safeguarding potassium levels. They are often used in combination with thiazides to prevent potassium deficiency (hypokalemia). Other diuretics include carbonic anhydrase inhibitors, which prevent hypocalcemia or hypercalcemia; osmotic diuretics, such as glucose, which retain water in the urine (used via infusion, for example, in renal failure); and aldosterone antagonists for intravenous use in heart failure or liver cirrhosis.
Herbal, natural, and pharmaceutical diuretics.
In drug processing, diuretics are a chemically heterogeneous group of compounds that stimulate or inhibit the production of various hormones naturally occurring in the body to regulate urine production by the kidneys. Herbal diuretics are sometimes referred to as aquaretics, and include applications (often teas) of horsetail, parsley, celery, nettle, or black currant. Various formulations and directions for use can be found in Hildegard von Bingen medicine as well as in herbal medicine. Traditional combination preparations with diuretic active components also consist of wild garlic, mistletoe and hawthorn. Homeopathic remedies to promote excretion are Urtica urens, Berberis, Calcium Carbonicum or Digitalis. Coffee, tea as well as alcohol are also diuretic beverages, but no medicinal effect is attributed to them. In Germany, more than 100 diuretic preparations with different dosages can currently be found, ranging from over-the-counter generics to prescription diuretics such as Esidrix, Aquaphor, Hygroton or Dytide H. Often, diuretics in the form of water tablets are recommended in diet forums as a tip for losing weight quickly, although this is not advised due to the complex mode of action.
Risks and side effects
Diuretics are generally safe, but can have side effects if used continuously or overdosed. The most common side effect of diuretics is usually increased urination.Other side effects include a decrease in blood volume, disturbances in electrolyte balance such as potassium deficiency or excess, hyponatremia (insufficient sodium level), blood level disturbances (hyperacidity, alkalinity) or an increase in uric acid levels in the blood. This can lead to complications such as dizziness, headaches, increased thirst, muscle cramps, increased cholesterol levels, rashes, joint disorders (gout), impotence or menstrual irregularities. The different modes of action carry various risks and side effects. Loop diuretics, for example, cause a marked increase in calcium excretion, which can lead to decreased bone density.
