Low-dose diuretic combination therapy in renal failure

Thiazide are generally believed to be ineffective diuretics when the glomerular filtration rate (GFR) is less than 30 ml/min. The present experiments demonstrate that thiazides are effective in increasing the excretion of sodium even in end-stage renal failure as it has been known for loop diuretics. The efficacy of the latter can be optimised by combination with thiazides. Thiazides namely prevent early-distal tubular hyperreabsorption following Long-term loop-diuretics-induced blockade of sodium transport in the loop of Henle. For these reasons, low-dose combinations of different diuretics induce 'segmental nephron blockade and are, therefore, potentially more clinically effective and safer than high doses of single compounds.