Chlorthalidone Pathway


Chlorthalidone, a thiazide diuretic, inhibits water reabsorption in the nephron by inhibiting the sodium-chloride symporter (SLC12A3) in the distal convoluted tubule, which is responsible for 5% of total sodium reabsorption. Normally, the sodium-chloride symporter transports sodium and chloride from the lumen into the epithelial cell lining the distal convoluted tubule. The energy for this is provided by a sodium gradient established by sodium-potassium ATPases on the basolateral membrane. Once sodium has entered the cell, it is transported out into the basolateral interstitium via the sodium-potassium ATPase, causing an increase in the osmolarity of the interstitium, thereby establishing an osmotic gradient for water reabsorption. By blocking the sodium-chloride symporter, chlorthalidone effectively reduces the osmotic gradient and water reabsorption throughout the nephron.

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References

  1. Brater, D.C. (2000). Pharmacology of diuretics. American Journal of Medical Sciences, 319(1), 38-50. PMID: 10653443
  2. Davies, D.L., & Wilson, G.M. (1975). Diuretics: mechanism of action and clinical application. Drugs, 9(3), 178-226. PMID: 1092541
  3. Thiazide diuretics. (2009). [Electronic version]. e-CPS. Retrieved June 5, 2009.