Final answer:
Indapamide (Lozol) is a thiazide diuretic that remains effective even when GFR drops below 30 mL/min, making it suitable for patients with impaired kidney function. It works by inhibiting the Na/Cl symporter in the DCT, resulting in increased excretion of sodium, chloride, and water, which helps to lower blood pressure.
Step-by-step explanation:
The question pertains to the identification of a thiazide diuretic that maintains efficacy at glomerular filtration rates (GFR) below 30 mL/min. Among the listed medications, indapamide (Lozol) is known for this characteristic. Unlike other diuretics like hydrochlorothiazide, which are less effective at low GFR levels, indapamide can still help reduce blood volume and control hypertension even when kidney function is impaired. This is relevant because as GFR decreases, the risk of drug accumulation increases and drug dosages must be carefully managed to avoid toxicity. Determining GFR accurately is important for appropriate dosing, particularly as GFR is commonly estimated by measuring serum creatinine levels in clinical practice.
As a diuretic, indapamide works by inhibiting the Na/Cl symporter in the distal convoluted tubule (DCT), leading to an increase in the excretion of sodium and chloride ions followed by water, thereby decreasing blood pressure. It is important for healthcare providers to choose the most effective diuretic, considering the patient's renal function, to manage conditions such as hypertension effectively without causing adverse effects.