Difference between Loop and Thiazide Diuretics in Calcium Metabolism

Loop and thiazide diuretics have common clinical uses like in the treatment of hypertension, heart failure, edema, etc. But they have different actions in calcium excretion or retention.

Loop Diuretics like Furosemide, Torsemide work by inhibiting Na+/K+/2CL- transporter in the thick ascending limb of the loop of Henle. Inhibition of this co-transporter causes loss of sodium, potassium into the urine, and drives loss of water. It also results in loss of lumen positive potential and decreases reabsorption of divalent ions like calcium. Thus there is increased loss of calcium in the urine.

Thus loop diuretics can be used in the treatment of hypercalcemia.
But they increase the chances of developing kidney stones.

Thiazide diuretics like hydrochlorothiazide work by inhibiting NaCl transport in the early segment of DCT. Thus reduce intracellular sodium and increase the exchange of sodium and chloride in the basolateral membrane. Thus they increase calcium resorption and thus decrease calcium content in the urine.

Thus thiazides have the opposite effect and can be used in the prevention of renal stones.

The picture below helps medical students easily remember the effects of loop and thiazides in body calcium and its implications.

This article is about easy to understand, retain, and recall medical info and mnemonics for medicine learners.

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