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Loop diuretics are pharmacological agents that primarily inhibit the Na-K-Cl cotransporter located on the luminal membrane of cells along the thick ascending limb of the loop of Henle. [4] They are often used for the treatment of hypertension and edema secondary to congestive heart failure , liver cirrhosis , or chronic kidney disease .
Hydrochlorothiazide, sold under the brand name Hydrodiuril among others, is a diuretic medication used to treat hypertension and swelling due to fluid build-up. [4] Other uses include treating diabetes insipidus and renal tubular acidosis and to decrease the risk of kidney stones in those with a high calcium level in the urine. [4]
Thiazide diuretics also increase calcium reabsorption at the distal tubule. By lowering the sodium concentration in the tubule epithelial cells, thiazides indirectly increase the activity of the basolateral Na + /Ca 2+ antiporter to maintain intracellular Na + level, facilitating Ca 2+ to leave the epithelial cells into the renal interstitium.
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Chlortalidone is considered a first-line medication for treatment of high blood pressure. [2] Some recommend chlortalidone over hydrochlorothiazide. [1] [15] A meta-analysis of randomized controlled trials found that chlortalidone is more effective than hydrochlorothiazide for lowering blood pressure, while the two drugs have similar toxicity.