kidneys processing blood and separating out urine

Have Your Diuretics Stopped Working?

A common complaint that I see people having with diuretics is they stop working or become less effective. What exactly does this mean? Can a medication simply stop working? Why would your doctor put you on a different diuretic if the one you are taking stops working? Why does this new one work better than the one I have been using? There are a lot of things going on in your kidneys that are needed to know to answer these questions. We will go over the basics here and you should talk with your doctor if you want more detailed explanations on them.

Stay on top of this

Diuretics can stop working and that doesn’t mean anything bad necessarily. Different diuretics work on different parts of the kidney. If one stops working or doesn’t work as well, your doctor can change up your medications to see if something else works better. It is important to stay on top of this because you only see your doctor once or twice a year, and if you have issues well before an appointment, you need to relay this information to them so they can make changes that help you the best.

Your kidneys have a very long system for filtering out water and waste. We won’t get into it here, but if you look up a picture of a nephron, the part of your kidney that is responsible for filtration, you will see its an intense system. When one medication stops working, it is good to find another that will focus on another part of the nephron as not to try to work a part of your kidney that isn’t responding to medication.

A delicate balance

I would suggest asking your doctor about possibly using a diuretic less if possible. You may want to ask about trying to limit fluid intake to see if you can take less of your diuretic and allow your body to attempt to do its own fluid removal. It’s a delicate balance and you don’t want to put yourself in danger by trying it, but diuretics do put a heavy workload on your kidneys and in time can cause permanent damage if you aren’t careful. It is a delicate balance when battling problems such as edema that are an immediate threat and trying to ward off future threats such as kidney failure.

What if no diuretics work?

What if no diuretics work? This is what I would consider an urgent to an emergency situation. You need to call your doctor immediately or go to an emergency room. Be upfront and honest about what you have been and are taking and responses you have had to each medication. You also want to make sure they check kidney function. It is possible you are having acute kidney failure, which sometimes can be reversed, or have chronic kidney failure, which needs to be addressed right away.

Make sure you are keeping your doctor up to date on how your diuretics are working and make sure to talk about kidney function and alternatives every visit. It doesn’t hurt to ask what they think about maybe scaling back to see what happens or maybe even alternating diuretics to help preserve kidney function.

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