Acute Effects of Various Diuretics on Lithium Clearance. Studies in Rats on Medium and Low Sodium Diet

Previous studies have shown that the clearance of lithium (CLi) is a quantitative measure of the delivery of tubular fluid to Henle's loop in rats given food with an ordinary or high sodium content, but not in rats given food with a low sodium content, because under these latter circumstances lithium is also reabsorbed to some extent in the distal nephron. The present study examines the effect of acetazolamide, hydrochlorothiazide, furosemide, and amiloride on the distal reabsorption of lithium in conscious rats with hereditary diabetes insipidus fed standard diets with medium (300 mmol Na/kg) and low (5 mmol Na/kg) sodium contents, respectively. Low sodium diet induced distal Li reabsorption, as apparent from the decrease in CLi and a fall in the urine/plasma lithium concentration ratio (U/P)Li, to below 1.0. Amiloride and furosemide abolished the distal Li reabsorption. Acetazolamide also abolished distal Li reabsorption and, in addition, it increased the fluid output from the proximal tubules. Hydrochlorothiazide was unable to abolish distal Li reabsorption.