Diuresis
Treatments
HCTZ and furosemide are hypoxanthine similar.
HCTZ is a PNP activator (increases depression 4025632, 8240880, case report with suicidal behavior 14648436, review 4456432 due to depletion of inosine),
Furosemide is a PNP inhibitor (reduces risk of Parkinson's disease 36054665).
Furosemide interferes with oxypurinol 22539486, ACEi/ARB 12167377 (free)
Nicotine has a long-known diuretic effect 35297, 4440764 consistent with hypoxanthine-analogue PNP inhibition that interferes with furosemide 5558129, 2407422.
Symptoms
Treatment-resistant psychosis is often associated with increased frequency of urination and urinary incontinence, in both men and women.
When measured, the volume of urine can be surprisingly different than normal.
Contrast-induced Renal failure
Acute renal failure is associated with excess uric acid production, and is common following administration of iodinated CT contrast agents iohexol, iodixanol, and ioversol. The most prominent purine-analogue structure is hypoxanthine: similar to analogous structures in risperidone, trazodone, as well as HCTZ, and furosemide, blurred vision is a listed side-effect of iohexol.
These agents also carry the apparent active site consistent with hypothesized PNP activation for L-DOPA, tetrabenazine, etc. Giving a PNP inducer together with PNP inhibitor furosemide causes increased nephrotoxicity per meta-analysis: PMID 18283206, whereas xanthine-similar N-acetylcysteine (PNP vs. XO activator: increases uric acid in dialysis patients PMID 27418761) and 1,3 dimethyl xanthine (theophylline) can decrease contrast-induced nephropathy PMID 18283206.
Gabapentin Renal Toxicity
Gabapentin: xanthine-similar, mild PNP activator?, can induce renal toxicity/ ARF: PMID 20362757
Renal Toxicity of Diuretics
Diuretic use is associated with increased nephrotoxicity and mortality in critically ill patients PMID 12444861.