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Nephrol Dial Transplant (1989) 4: 939-942
© 1989 European Renal Association-European Dialysis and Transplant Association

research-article

Triamterene Increases Lithium Excretion in Healthy Subjects: Evidence for Lithium Transport in the Cortical Collecting Tubule

J. F. M. Wetzels, J. D. van Bergeijk, A. J. Hoitsma, F. Th. M. Huysmans and R. A. P. Koene

Department of Medicine, Division of Nephrology, University Hospital Nijmegen Nijmegen, The Netherlands

Correspondence and offprint requests to: Correspondence and offprint requests to: J. F. M. Wetzels, MD, Department of Medicine, Division of Nephrology, University Hospital Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Phone: 080-514761

The possible presence of lithium transport beyond the proximal tubule was examined by measuring lithium excretion after administration of triamterene, a potassium-sparing diuretic, exclusively acting in the cortical collecting tubule. Eight young and healthy volunteers were studied on two occasions during maximal water diuresis. After obtaining baseline values triamterene (100mg orally) or placebo was administered, and measurements continued for 4 hours. Creatinine clearance was used as a marker of glomerular filtration rate, and phosphate excretion was used as an additional marker of proximal sodium transport. Compared to placebo (P), triamterene (T) caused a significant increase in fractional excretion of sodium (P, 0.74±0.08%; T, 1.73±0.24%, mean±SEM; P<0.01), and lithium (P, 21.2±1.3%; T, 27.5±1.5%; P<0.01), whereas fractional excretion of phosphate remained unchanged (P, 9.8±1.3%; T, 9.4±1.5%; P=NS). These results indicate that lithium is transported in the cortical collecting tubule, and provide further evidence that the use of lithium as a marker of purely proximal tubular sodium transport is of limited value.

Keywords: Lithium clearance; Triamterene; Segmental sodium reabsorption; Free water clearance


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