Knowledge (XXG)

Osmotic diuretic

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Any osmotically active agent that is filtered by the glomerulus but not reabsorbed causes water to be retained in these segments and promotes a water diuresis. Such agents can be used to reduce intracranial pressure and to promote prompt removal of renal toxins. The prototypical osmotic diuretic is
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Osmotic diuretics have their major effect in the proximal convoluted tubule and the descending limb of the Loop of Henle. These sites are freely permeable to water. Through osmotic effects, they also oppose the action of ADH in the collecting tubule. The presence of a nonreabsorbable solute such as
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The increase in urine flow rate decreases the contact time between fluid and the tubular epithelium, thus reducing sodium as well as water reabsorption. The resulting natriuresis is of lesser magnitude than the water diuresis, leading eventually to excessive water loss and hypernatremia.
115:, and cerebral blood volume is decreased. The second effect occurs through creation of an osmotic gradient across the blood-brain barrier, leading to the movement of water from the parenchyma to the intravascular space. Brain tissue volume is decreased and, therefore, ICP is lowered. 205:
Sakowitz OW, Stover JF, Sarrafzadeh AS, Unterberg AW, Kiening KL (February 2007). "Effects of mannitol bolus administration on intracranial pressure, cerebral extracellular metabolites, and tissue oxygenation in severely head-injured patients".
87:. Osmotic diuretics increase plasma volume, but because they do not cross the blood-brain barrier, this does not affect the nervous system. In effect, this is the cause of their action reducing locally the plasma volume in the nervous system. 142: 256:
Messeter, Kenneth; Nordström, Carl-Henrik; Sundbärg, Göran; Algotsson, Lars; Ryding, Erik (February 1986). "Cerebral hemodynamics in patients with acute severe head trauma".
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mannitol prevents the normal absorption of water by interposing a countervailing osmotic force. As a result, urine volume increases.
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from concentrating urine, which usually uses the high osmotic and solute gradient to transport solutes and water.
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Osmotic diuretics work by expanding extracellular fluid and plasma volume, therefore increasing blood flow to the
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James, H. E. (September 1980). "Methodology for the control of intracranial pressure with hypertonic mannitol".
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These agents can also act at other parts of the body. For example, they can be used to reduce
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Mannitol lowers the intra cranial pressure through two effects in the brain. The first,
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of blood and renal filtrate. This fluid eventually becomes urine.
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Goodman & Gilman's: The Pharmacological Basis of Therapeutics
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Index

Diuretics, osmotic
diuretic
sodium
osmolarity
mannitol
isosorbide
nephron
kidney
cortical medullary gradient
loop of Henle
intracranial
intra-ocular pressure
rheological effect
autoregulation
Osmosis
"osmotic diuretic"
Dorland's Medical Dictionary
"Mannitol"
ISBN
0-07-139930-5
doi
10.1097/01.ta.0000203560.03937.2d
PMID
17297315
doi
10.3171/jns.1986.64.2.0231
ISSN
0022-3085
PMID
3080555

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