renal agents


Summary: Drugs used for their effects on the kidneys' regulation of body fluid composition and volume. The most commonly used are the diuretics. Also included are drugs used for their antidiuretic and uricosuric actions, for their effects on the kidneys' clearance of other drugs, and for diagnosis of renal function.

Top Publications

  1. Glazener C, Evans J, Peto R. Treating nocturnal enuresis in children: review of evidence. J Wound Ostomy Continence Nurs. 2004;31:223-34 pubmed
    ..Patients and their families need to be warned about possible side effects of some of the drugs. Alarms are the most effective treatment for nocturnal enuresis in children, but desmopressin may be considered for temporary relief. ..
  2. Bardoux P, Bichet D, Martin H, Gallois Y, Marre M, Arthus M, et al. Vasopressin increases urinary albumin excretion in rats and humans: involvement of V2 receptors and the renin-angiotensin system. Nephrol Dial Transplant. 2003;18:497-506 pubmed
    ..These results bring additional support for an involvement of vasopressin in the albuminuria observed in pathological states such as diabetes mellitus or hypertension. ..
  3. Bosson S, Holland P, Barrow S. A visual motor psychological test as a predictor to treatment in nocturnal enuresis. Arch Dis Child. 2002;87:188-91 pubmed
    ..We postulated that in some children there might be a delay in maturation of the normal neurological pathways involved in establishment of nocturnal continence and examined this by using a specific neuropsychological test...
  4. Marr N, Bichet D, Lonergan M, Arthus M, Jeck N, Seyberth H, et al. Heteroligomerization of an Aquaporin-2 mutant with wild-type Aquaporin-2 and their misrouting to late endosomes/lysosomes explains dominant nephrogenic diabetes insipidus. Hum Mol Genet. 2002;11:779-89 pubmed
  5. El Hennawy A, Bassi T, Koradia N, Bocirnea A. Transient gestational diabetes insipidus: report of two cases and review of pathophysiology and treatment. J Matern Fetal Neonatal Med. 2003;14:349-52 pubmed
    ..Understanding of the pathophysiology may soon lead to improved methods of prevention, diagnosis and treatment. ..
  6. Zhou Z, Bubien J. Nongenomic regulation of ENaC by aldosterone. Am J Physiol Cell Physiol. 2001;281:C1118-30 pubmed
    ..These functional studies are consistent with aldosterone membrane binding studies, suggesting the presence of a plasma membrane steroid receptor that affects cellular processes by mechanisms unrelated to altered gene expression. ..
  7. Vajda Z, Pedersen M, Doczi T, Sulyok E, Stødkilde Jørgensen H, Frøkiaer J, et al. Effects of centrally administered arginine vasopressin and atrial natriuretic peptide on the development of brain edema in hyponatremic rats. Neurosurgery. 2001;49:697-704; discussion 704-5 pubmed
    ..The results emphasize the direct effects of these hormones on the cellular volume regulatory mechanisms in the brain during the development of cerebral edema. ..
  8. Bussolati B, Deregibus M, Fonsato V, Doublier S, Spatola T, Procida S, et al. Statins prevent oxidized LDL-induced injury of glomerular podocytes by activating the phosphatidylinositol 3-kinase/AKT-signaling pathway. J Am Soc Nephrol. 2005;16:1936-47 pubmed
    ..The statin-induced Akt activation may protect from the loss of nephrin by an inhibition of its redistribution and shedding and by a stimulation of its synthesis. These data provide a rationale for the anti-proteinuric effect of statins. ..
  9. Leng L, Boldizárová K, Faix S, Kovac G. The urinary excretion of selenium in sheep treated with a vasopressin analogue. Vet Res. 2000;31:499-505 pubmed
    ..The results presented suggest that vasopressin may contribute to maintenance of the selenium balance in sheep via its effects on renal function. ..

More Information


  1. Sanchez J, Olmedo M, Pascua F, Casado I. [Diabetes insipidus as a manifestation of cerebral toxoplasmosis in an AIDS patient]. Rev Neurol. 2000;30:939-40 pubmed
    ..In patients with HIV infection, DI, although uncommon, may be the first sign of cerebral toxoplasmosis. Imaging studies may be pathological and assist diagnosis. ..
  2. Katsuda H, Yamashita M, Katsura H, Yu J, Waki Y, Nagata N, et al. Protecting cisplatin-induced nephrotoxicity with cimetidine does not affect antitumor activity. Biol Pharm Bull. 2010;33:1867-71 pubmed
    ..From these results, cimetidine clearly inhibits nephrotoxicity induced by cisplatin without any influence on the antitumor activity of cisplatin on osteosarcoma in vitro and in vivo. ..
  3. Rembratt A, Graugaard Jensen C, Senderovitz T, Norgaard J, Djurhuus J. Pharmacokinetics and pharmacodynamics of desmopressin administered orally versus intravenously at daytime versus night-time in healthy men aged 55-70 years. Eur J Clin Pharmacol. 2004;60:397-402 pubmed
    ..Despite low bioavailability, the pharmacodynamic effects of oral desmopressin were similar in magnitude to those after intravenous dose at night and during the first 6 h after daytime administration. ..
  4. Eggert P, Fritz A, Stecker B, Muller D. Desmopressin has an influence on the arousability of children with primary nocturnal enuresis. J Urol. 2004;171:2586-8; discussion 2588 pubmed
    ..This result is consistent with the known action of DDAVP on sleep of elderly adults. It suggests that the cause of primary nocturnal enuresis lies in the structure of sleep of the affected patients. ..
  5. Huang C, Liu K, Cheng C, Lin Y, Lin M, Lin T. PGE2 enhances cytokine-elicited nitric oxide production in mouse cortical collecting duct cells. Nitric Oxide. 2005;12:150-8 pubmed
    ..While an increase in cAMP alone may enhance water reabsorption, a concomitant increase in cAMP and cytokines may inhibit water reabsorption in renal tubule. ..
  6. Goh S, Jasik M, Cooper M. Agents in development for the treatment of diabetic nephropathy. Expert Opin Emerg Drugs. 2008;13:447-63 pubmed
    ..Other approaches that at this stage do not appear to be progressing include the glycosaminoglycan sulodexide and the protein kinase C-beta (PKC-beta) inhibitor, ruboxistaurin. ..
  7. Duarte H, Ormonde L, Lima F. [The controversial use of dopamine in major vascular surgery]. Rev Port Cir Cardiotorac Vasc. 2004;11:213-6 pubmed
    ..There are, nowadays, enough scientific evidence demonstrating that renal doses of dopamine do not play a significant protective role of renal function in these critically ill patients. ..
  8. Hvistendahl G, Rawashdeh Y, Kamperis K, Hansen M, Rittig S, Djurhuus J. The relationship between desmopressin treatment and voiding pattern in children. BJU Int. 2002;89:917-22 pubmed
    ..Short-term desmopressin treatment does not affect functional and mean bladder capacity; 24-h urine production was reduced significantly (P<0.01) during desmopressin treatment. ..
  9. Park F, Zou A, Cowley A. Arginine vasopressin-mediated stimulation of nitric oxide within the rat renal medulla. Hypertension. 1998;32:896-901 pubmed
    ..3 microg/kg per minute). This study demonstrates that AVP increases renal medullary interstitial [NO] through vasopressin V2 receptor stimulation, which in turn elevates blood flow to the renal medulla. ..
  10. Navarro J, Mora C, Muros M, Garcia J. Additive antiproteinuric effect of pentoxifylline in patients with type 2 diabetes under angiotensin II receptor blockade: a short-term, randomized, controlled trial. J Am Soc Nephrol. 2005;16:2119-26 pubmed
    ..In conclusion, administration of PTF to patients who have type 2 diabetes and are under long-term treatment with an ARB produces a significant additive antiproteinuric effect associated with a reduction of urinary TNF-alpha excretion. ..
  11. Gomez Daspet J, Elko L, Grebenev D, Vesely D. Survival with serum sodium level of 180 mEq/L: permanent disorientation to place and time. Am J Med Sci. 2002;324:321-5 pubmed
    ..However, she developed permanent (6 months) disorientation to time and place even when hypernatremia was corrected, which has not been described previously. ..
  12. Skarke C, Langer M, Jarrar M, Schmidt H, Geisslinger G, Lotsch J. Probenecid interacts with the pharmacokinetics of morphine-6-glucuronide in humans. Anesthesiology. 2004;101:1394-9 pubmed
    ..05 vs. placebo). In contrast, quinidine pretreatment had no influence on the pharmacokinetics of M6G. The active morphine metabolite is subject to transmembrane transport by transporters inhibited by probenecid in humans. ..
  13. Myllynen P, Kurttila T, Vaskivuo L, Vahakangas K. DNA damage caused by benzo(a)pyrene in MCF-7 cells is increased by verapamil, probenecid and PSC833. Toxicol Lett. 2007;169:3-12 pubmed
  14. Lin S, Hsu Y, Chiu J, Chu S, Davids M, Halperin M. Osmotic demyelination syndrome: a potentially avoidable disaster. QJM. 2003;96:935-47 pubmed
    ..Adding quantitative analysis, the cause of the excessive rise in plasma sodium concentration is revealed, and a better plan for therapy is proposed. ..
  15. Tahara H, Kusuhara H, Maeda K, Koepsell H, Fuse E, Sugiyama Y. Inhibition of oat3-mediated renal uptake as a mechanism for drug-drug interaction between fexofenadine and probenecid. Drug Metab Dispos. 2006;34:743-7 pubmed
    ..These results suggest that the renal drug-drug interaction between fexofenadine and probenecid is probably explained by an inhibition of the renal uptake of fexofenadine via hOAT3, at least in part. ..
  16. Murray P. Fenoldopam: renal-dose dopamine redux?. Crit Care Med. 2006;34:910-1 pubmed
  17. Gerbutaviciene R, Klimas R, Savickas A, Maciulevicius J. [Development of formulations of desmopressin intranasal drops]. Medicina (Kaunas). 2002;38:545-9 pubmed
    ..According to our quality control data, desmopressin intranasal drops are stable for two years and remain sterile during storage and administration of the drug. ..
  18. Schaumburg H, Rittig S, Djurhuus J. No relationship between family history of enuresis and response to desmopressin. J Urol. 2001;166:2435-7 pubmed
    ..In contrast to previous reports, a positive family history failed to predict a good response to desmopressin treatment. Hereditary factors are important to consider in desmopressin responding and desmopressin resistant cases. ..
  19. Deschenes G, Gonin S, Zolty E, Cheval L, Rousselot M, Martin P, et al. Increased synthesis and avp unresponsiveness of Na,K-ATPase in collecting duct from nephrotic rats. J Am Soc Nephrol. 2001;12:2241-52 pubmed
  20. Bakhiya N, Arlt V, Bahn A, Burckhardt G, Phillips D, Glatt H. Molecular evidence for an involvement of organic anion transporters (OATs) in aristolochic acid nephropathy. Toxicology. 2009;264:74-9 pubmed publisher
    ..Our study indicates that OATs can mediate the uptake of AA into proximal tubule cells and thereby participate in kidney cell damage by this toxin...
  21. Huang T, Shu X, Huang Y, Cheuk D. Complementary and miscellaneous interventions for nocturnal enuresis in children. Cochrane Database Syst Rev. 2011;:CD005230 pubmed publisher
    ..Robust randomised trials are required with efficacy, cost-effectiveness and adverse effects clearly reported. ..
  22. Neveus T, Stenberg A, LAckgren G, Tuvemo T, Hetta J. Sleep of children with enuresis: a polysomnographic study. Pediatrics. 1999;103:1193-7 pubmed
    ..09). The enuretic event is a predominantly non-rapid eye movement sleep phenomenon. Responders and nonresponders to desmopressin treatment void during different parts of the night. ..
  23. Levtchenko E, Monnens L. Development of Fanconi syndrome during infancy in a patient with cystinosis. Acta Paediatr. 2006;95:379-80 pubmed
  24. Rittig S, Jensen A, Jensen K, Pedersen E. Effect of food intake on the pharmacokinetics and antidiuretic activity of oral desmopressin (DDAVP) in hydrated normal subjects. Clin Endocrinol (Oxf). 1998;48:235-41 pubmed
    ..It is possible that administration of desmopressin in the fasting state may prolong its duration of action. ..
  25. Bankir L, Fernandes S, Bardoux P, Bouby N, Bichet D. Vasopressin-V2 receptor stimulation reduces sodium excretion in healthy humans. J Am Soc Nephrol. 2005;16:1920-8 pubmed
    ..The possibility that an inappropriate stimulation of ENaC by vasopressin might lead to significant sodium retention in chronic situations remains to be determined. ..
  26. Mathieson P. Update on the podocyte. Curr Opin Nephrol Hypertens. 2009;18:206-11 pubmed
    ..Currently available agents can be harnessed in this way and the rapid progress in the study of podocytes is highlighting new therapeutic targets that can bring even more specificity. ..
  27. Al Salloum A, Muthanna A, Bassrawi R, Al Shehab A, Al Ibrahim A, Islam M, et al. Long-term outcome of the difficult nephrotic syndrome in children. Saudi J Kidney Dis Transpl. 2012;23:965-72 pubmed publisher
    ..We suggest longer initial treatment at onset for this group of patients. The low incidence of infection in this group needs to be addressed in future studies. ..
  28. Castle J, Butts M, Healey A, Kent K, Marino M, Feinstein S. Ultrasound-mediated targeted drug delivery: recent success and remaining challenges. Am J Physiol Heart Circ Physiol. 2013;304:H350-7 pubmed publisher
    ..The clinical utility and eventual clinical successes await vigorous testing. This review highlights the recent successes and challenges within the field of ultrasound-mediated drug delivery. ..
  29. Ecelbarger C, Chou C, Lee A, DiGiovanni S, Verbalis J, Knepper M. Escape from vasopressin-induced antidiuresis: role of vasopressin resistance of the collecting duct. Am J Physiol. 1998;274:F1161-6 pubmed
  30. Szentivanyi M, Park F, Maeda C, Cowley A. Nitric oxide in the renal medulla protects from vasopressin-induced hypertension. Hypertension. 2000;35:740-5 pubmed
  31. Ghosh P, Bedolla R, Thomas C, Kreisberg J. Role of protein kinase C in arginine vasopressin-stimulated ERK and p70S6 kinase phosphorylation. J Cell Biochem. 2004;91:1109-29 pubmed
    ..Our results indicate that PKCdelta plays an important role in AVP-stimulated ERK and p70S6 kinase activation and cell proliferation. ..
  32. Schulman S, Stokes A, Salzman P. The efficacy and safety of oral desmopressin in children with primary nocturnal enuresis. J Urol. 2001;166:2427-31 pubmed
    ..05). An acceptable response to treatment (50% or greater reduction from baseline in wet nights per 2 weeks) was seen at all doses of desmopressin. Oral desmopressin, up to 0.6 mg. for 8 weeks, was well tolerated. ..
  33. Rembratt A, Norgaard J, Andersson K. Desmopressin in elderly patients with nocturia: short-term safety and effects on urine output, sleep and voiding patterns. BJU Int. 2003;91:642-6 pubmed
    ..Desmopressin was well tolerated in elderly patients with nocturia, but the results suggest that serum sodium should be measured before and after a few days of treatment. ..
  34. Handa R, Strandhoy J, Giammattei C, Handa S. Platelet-activating factor and solute transport processes in the kidney. Am J Physiol Renal Physiol. 2003;284:F274-81 pubmed
  35. Amorim J, Musa Aziz R, Mello Aires M, Malnic G. Signaling path of the action of AVP on distal K+ secretion. Kidney Int. 2004;66:696-704 pubmed
    ..The results suggest that the luminal V1-receptor effect of AVP on JK was mediated by the phospholipase C (PLC)/Ca2+/PKC signaling path and not byadenylate cyclase/cAMP/PKA, therefore probably acting on maxi-potassium channels. ..
  36. Foote E, Halstenson C. Effects of probenecid and cimetidine on renal disposition of ofloxacin in rats. Antimicrob Agents Chemother. 1998;42:456-8 pubmed
    ..In the presence of cimetidine or probenecid, ofloxacin's total and renal clearances were reduced and its half-life was prolonged. This suggests that ofloxacin is secreted by both the anionic and cationic transport systems. ..
  37. Hensen J, Henig A, Fahlbusch R, Meyer M, Boehnert M, Buchfelder M. Prevalence, predictors and patterns of postoperative polyuria and hyponatraemia in the immediate course after transsphenoidal surgery for pituitary adenomas. Clin Endocrinol (Oxf). 1999;50:431-9 pubmed
    ..This study was performed to examine the prevalence and predictors of polyuria and hyponatraemia after a complete and selective removal of pituitary adenomas was attempted via the transnasal-transsphenoidal approach...
  38. Saegusa Y, Sadakane C, Koseki J, Hasegawa Y, Shindo S, Maruyama H, et al. Effect of TJN-331 on anti-Thy1 nephritis in rats via inhibition of transforming growth factor-?1 production. Biol Pharm Bull. 2010;33:1710-5 pubmed
    ..These results suggest that TJN-331 and tranilast prevent expansion of the mesangial area by suppression of TGF-?1 secretion from inflamed glomeruli. ..
  39. Marild S, Rembratt A, Jodal U, Nørgaard J. Renal concentrating capacity test using desmopressin at bedtime. Pediatr Nephrol. 2001;16:439-42 pubmed
    ..Night-time desmopressin therefore offers the potential of a user-friendly RCCT in patients with suspected impairment of renal tubular function. ..
  40. Cardenas A, Arroyo V. Hepatorenal syndrome-pathogenesis and treatment. Curr Gastroenterol Rep. 2002;4:1-4 pubmed
  41. Ljung R. Use of desmopressin and concomitant use of potentially interacting drugs in elderly patients in Sweden. Eur J Clin Pharmacol. 2008;64:439-44 pubmed publisher
    ..Increased awareness of potentially interacting concomitant medication can improve medication safety in this fragile group. ..
  42. Abernethy V, Lieberthal W. Acute renal failure in the critically ill patient. Crit Care Clin. 2002;18:203-22, v pubmed
    ..In addition, some unusual causes of acute renal failure that occur predominantly in the intensive care unit are briefly discussed. ..
  43. Lyon C, Schnall J. What is the best treatment for nocturnal enuresis in children?. J Fam Pract. 2005;54:905-6, 909 pubmed
    ..Dry bed training with an alarm results in an additional reduction of wet nights over alarms alone (SOR: A, based on a systematic review of homogeneous RCTs.). ..
  44. Bakr A. Prophylactic theophylline to prevent renal dysfunction in newborns exposed to perinatal asphyxia--a study in a developing country. Pediatr Nephrol. 2005;20:1249-52 pubmed
    ..Prophylactic theophylline treatment, given early after birth, has beneficial effects in reducing the renal involvement in asphyxiated full-term infants, with no significant changes in central nervous system involvement. ..
  45. Lose G, Lalos O, Freeman R, van Kerrebroeck P. Efficacy of desmopressin (Minirin) in the treatment of nocturia: a double-blind placebo-controlled study in women. Am J Obstet Gynecol. 2003;189:1106-13 pubmed
    ..Two deaths occurred, although neither could be directly associated with the study drug. Oral desmopressin is an effective and well-tolerated treatment for nocturia in women. ..
  46. Khanna A, Simoni J, Wesson D. Endothelin-induced increased aldosterone activity mediates augmented distal nephron acidification as a result of dietary protein. J Am Soc Nephrol. 2005;16:1929-35 pubmed
    ..The data support that dietary protein provided as casein increases distal nephron acidification through endothelin-stimulated Na+/H+ exchange and endothelin-stimulated aldosterone secretion that increases H+-ATPase activity. ..
  47. Akbal C, Ekici S, Erkan I, Tekgul S. Intermittent oral desmopressin therapy for monosymptomatic primary nocturnal enuresis. J Urol. 2004;171:2603-6 pubmed
    ..5%). For some enuretic patients with relapse after cessation of initial 3-month therapy, intermittent DDAVP may be an effective alternative long-term treatment. ..
  48. Thomas C, Loftus R, Liu K. AVP-induced VIT32 gene expression in collecting duct cells occurs via trans-activation of a CRE in the 5'-flanking region of the VIT32 gene. Am J Physiol Renal Physiol. 2004;287:F460-8 pubmed
    ..Finally, we were able to identify CREB as a nuclear protein that bound to the VIT32 CRE in gel mobility shift assays. In summary, DDAVP stimulates transcription of VIT32 via a CRE within the proximal promoter region of the VIT32 gene. ..
  49. Santos R, Haibara A, Campagnole Santos M, Simoes e Silva A, Paula R, Pinheiro S, et al. Characterization of a new selective antagonist for angiotensin-(1-7), D-pro7-angiotensin-(1-7). Hypertension. 2003;41:737-43 pubmed
    ..These data indicate that D-Pro7-Ang-(1-7) is a selective antagonist for Ang-(1-7), which can be useful to clarify the functional role of this heptapeptide. ..
  50. Shuai B, Shen L, Yang Y, Xie J, Zhou P, Li H, et al. [Effects of Chinese kidney-tonifying drugs on bone mineral density (BMD), biomechanics, 25-hydroxy vitamin D3 and 1,25-dihydroxy vitamin D3 of ovariectomized osteoporosis rats]. Zhongguo Gu Shang. 2008;21:850-3 pubmed
  51. Song J, Hu X, Khan O, Tian Y, Verbalis J, Ecelbarger C. Increased blood pressure, aldosterone activity, and regional differences in renal ENaC protein during vasopressin escape. Am J Physiol Renal Physiol. 2004;287:F1076-83 pubmed
    ..11beta-HSD-2 was increased by dDAVP in the cortex and not significantly affected by water loading. These changes may serve to attenuate Na(+) losses and ameliorate hyponatremia in vasopressin escape. ..
  52. Mizuno H, Sugiyama Y, Ohro Y, Imamine H, Kobayashi M, Sasaki S, et al. Clinical characteristics of eight patients with congenital nephrogenic diabetes insipidus. Endocrine. 2004;24:55-9 pubmed
    ..Results of 99mTc-diethylenetriamine pentaacetic acid kidney scintigraphy revealed a slight decrease in glomerular filtration rate in three patients. No patient experienced serious renal dysfunction. ..
  53. Fritz G, Rockney R, Bernet W, Arnold V, Beitchman J, Benson R, et al. Practice parameter for the assessment and treatment of children and adolescents with enuresis. J Am Acad Child Adolesc Psychiatry. 2004;43:1540-50 pubmed
    ..The psychosocial consequences of the symptom must be recognized and addressed with sensitivity during the evaluation and treatment of enuresis...