Physiological Working of Osmotic Diuretics
The renal proximal tubule is the primary site of action of osmotic diuretics.
Normally, water molecules follow Na+ out of the proximal tubule, resulting in Na+ and water reabsorption. When osmotic diuretics are introduced, they hold onto water molecules in the tubule. Since the luminal membrane is quite leaky to Na+, this causes a high back leak of Na+ into the tubule.
Na+ is normally followed by K+ and Cl- out of the proximal tubule. When there is high back leak of Na+, these electrolytes stay in the tubule and are lost through urine.
Note: Glucose is completely reabsorbed by the kidneys but not Mannitol.
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