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December 1958

Nonmercurial Organic Diuretics: Their Action and Application

Author Affiliations

West Point, Pa.

Merck Sharp and Dohme Research Laboratories.

AMA Arch Intern Med. 1958;102(6):1005-1015. doi:10.1001/archinte.1958.00260230151019

The renotropic effect of diuretic agents is employed clinically to induce a more favorable balance between the glomerular filtration of plasma water and the reabsorption of "salt" and water by the renal tubules. As illustrated in Figure 1, it is attractive to consider that with the pathogenesis of cardiovascular-renal disease there may be phases of progressive imbalance between the reduction in glomerular filtration and the smaller diminution of tubule functional capacity that favors a relatively greater percentage reabsorption of electrolytes and water by the renal tubules. This process may be anticipated to contribute to an increasing percentage reabsorption of the glomerular filtrate leading to the accumulation of fluid in tissues and, ultimately, in body cavities.1,2 The same net effect would obtain under circumstances where glomerular filtration rate is not necessarily diminished but where there is more than commensurate reabsorption of electrolytes, as under the influence of increased production or

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