GENERAL HISTOLOGY

Detailed explanation-1: -Loop diuretics are the recommended diuretics for patients who have an estimated glomerular filtration rate (eGFR)<30 mL/min/1.73m2 because other diuretics, including thiazide, are less effective in advanced CKD15). The natriuretic response to furosemide is also reduced in patients with CKD4).

Detailed explanation-2: -Hydrochlorothiazide (HCTZ): thiazide diuretic less potent than furosemide but more gentle with nearly 24 hour length of action. Commonly used with normal or better preserved kidney function. Also used to decrease calcium elimination by the kidneys to reduce the risk of forming calcium kidney stones.

Detailed explanation-3: -Bumetanide, furosemide and torsemide are frequently used loop diuretics. The bioavailability of loop diuretics is not affected by the presence of CKD.

Detailed explanation-4: -Bumex is a loop diuretic with a rapid onset and short duration of action. Pharmacological and clinical studies have shown that 1 mg Bumex has a diuretic potency equivalent to approximately 40 mg furosemide. The major site of Bumex action is the ascending limb of the loop of Henle.