Figure 3

Pharmacodynamics of thiazide diuretics. This is a schematicreproduction of the kidney distal convoluted tubule. Sodiumretention is driven by basolateral Na⁺K⁺ATPase throughout the kidney [86]. Creatine kinase (CK), reported to be high in persons ofAfrican ancestry [11, 12, 72, 73], is tightly bound near basolateralNa⁺K⁺ ATPase, where it rapidly regeneratesATP to facilitate sodium retention [87]. Enhanced sodium retention occurs more frequently inpersons of African ancestry [96]. Thiazide diuretics counteract this effect, albeitindirectly and partly, through inhibition of luminalNa⁺Cl⁻ -cotransport.