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Video Summary:
Hypocalcemia is one of the side effects of loop diuretics. To understand how they cause hypocalcemia, we need to first understand the underlying physiology for calcium reabsorption in thick ascending limb of loop of Henle first. In thick ascending limb of loop of Henle, Na, K and Cl are transported along the apical membrane by Na-K-2Cl cotransporter. Then from cell, Na is extruded into interstitium by Na-K ATPase pump and Cl diffuse in same direction by Cl channels. But K leaks back into the lumen through K channels. As positively charge K moves to lumen and negatively charge Cl moves to interstitium, lumen becomes electropositive as compared to interstitium. This electro-positivity repels positively charged ion like Ca and Mg. So these ions move out of lumen through paracellular space. This is what normally happens.
Loop diuretics inhibit activity of Na-K-2Cl cotransporter. So all these activities are decreased. Without electrical gradient, Ca reabsorption also decreases and more calcium is lost in urine. This causes Hypocalcemia.
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DISCLAIMER: This video is for education purpose only. Although every effort is made to ensure accuracy of material, viewer should refer to the appropriate regulatory body/authorised websites, guidelines and other suitable sources of information as deemed relevant and applicable. In view of possibility of human error or changes in medical science, any person or organization involved in preparation of this work accepts no responsibility for any errors or omissions or results obtained from use of information in this video.
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