WILLIAM B. SCHWARTZ, M.D.; ARNOLD S. RELMAN, M.D.; ALEXANDER LEAF, M.D.
The enzyme carbonic anhydrase, normally present in high concentration in renal tubular cells, is thought to be responsible for the reabsorption of bicarbonate. When this enzyme is temporarily inhibited by administration of unsubstituted sulfonamide compounds, bicarbonate excretion is increased, together with the excretion of sodium and other cations.1 With this loss of bicarbonate the urine becomes alkaline, plasma bicarbonate falls and a metabolic acidosis develops.2
The use of a carbonic anhydrase inhibitor as a diuretic was first suggested by Schwartz,3 who showed that sulfanilamide produced small diureses in some subjects with congestive heart failure. Recently a new and less
SCHWARTZ WB, RELMAN AS, LEAF A. ORAL ADMINISTRATION OF A POTENT CARBONIC ANHYDRASE INHIBITOR ("DIAMOX"). III. ITS USE AS A DIURETIC IN PATIENTS WITH SEVERE CONGESTIVE HEART FAILURE DUE TO COR PULMONALE1. Ann Intern Med. 1955;42:79–89. doi: 10.7326/0003-4819-42-1-79
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Published: Ann Intern Med. 1955;42(1):79-89.
Cardiology, Heart Failure.
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