Pharmacodynamics of thiazide diuretics. This is a schematic reproduction of the kidney distal convoluted tubule. Sodium retention is driven by basolateral Na+K+ ATPase throughout the kidney . Creatine kinase (CK), reported to be high in persons of African ancestry [11,12,72,73], is tightly bound near basolateral Na+K+ ATPase, where it rapidly regenerates ATP to facilitate sodium retention . Enhanced sodium retention occurs more frequently in persons of African ancestry . Thiazide diuretics counteract this effect, albeit indirectly and partly, through inhibition of luminal Na+Cl− -cotransport.
Brewster and Seedat BMC Medicine 2013 11:141 doi:10.1186/1741-7015-11-141