Sites of action of tripamide

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Abstract
Tripamide is a new diuretic derived from a sulfonamide nucleus that has both antihypertensive and natriuretic properties. Its renal site of effect was assessed with standard clearance techniques in humans. Studies during water loading indicated a 47% increase in fractional free water clearance (an effect opposite that of thiazide diuretics) and a simultaneous 75% increase in fractional delivery of solute to the diluting segment. When free water clearance was assessed relative to delivery of solute, tripamide induced a decrease from from 0.86 .+-. 0.03 to 0.75 .+-. 0.01. This indicated an inhibitory effect on solute reabsorption at the cortical segment of the thick ascending limb of Henle''s loop. Studies during hydropenia indicated increased free water reabsorption. When factored for delivery of solute, free water reabsorption decreased from 0.66 .+-. 0.02 to 0.61 .+-. 0.02, indicating a site of effect of tripamide at the medullary segment of the thick ascending limb of Henle''s loop. Tripamide also increased Ca excretion. No effects on renal hemodynamics or indices of effect at the proximal tubule were observed. Tripamide is evidently a loop diuretic that may also affect more proximal nephron sites.

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