The objective of this paper is to review the pharmacology of diuretics and the applications of diuretics to sports doping, as well as detail the analytical methodologies currently described to detect and identify diuretics in urine. All the classes of diuretics detailed later in this paper are banned in sport. Diuretics are therapeutic agents that are used to increase the rate of urine flow and sodium excretion in order to adjust the volume and composition of body fluids or to eliminate excess of fluids from tissues Jackson, 2006. Diuretics were first banned in sport both in competition and out of competition in 1988 because they can be used by athletes for two primary reasons.
First, their potent ability to remove water from the body can cause a rapid weight loss that can be required to meet a weight category in sporting events. Second, they can be used to mask the administration of other doping agents by reducing their concentration in urine primarily because of an increase in urine volume. The urine dilution effect of diuretics also allows them to be classified as masking agents and precludes their use both in and out of competition. If overdose is suspected, contact a poison control center or emergency room immediately. The medicines are not curing or doing better; they are doing worst.
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There are several major categories of this drug class and the compounds vary greatly in structure, physicochemical properties, effects on urinary composition and renal haemodynamics, and site and mechanism of action. Diuretics are often abused by athletes to excrete water for rapid weight loss and to mask the presence of other banned substances. Because of their abuse by athletes, diuretics have been included on The World Anti-Doping Agency's WADA list of prohibited substances; the use of diuretics is banned both in competition and out of competition and diuretics are routinely screened for by anti-doping laboratories.
This review provides an overview of the pharmacology and toxicology of diuretics and discusses their application in sports. The most common analytical strategies currently followed by the anti-doping laboratories accredited by the WADA are discussed along with the challenges laboratories face for the analysis of this diverse class of drugs. With the huge financial incentives and the subsequent pressures to excel associated with the international sporting industry, attempts to achieve a competitive edge especially with the use of performance-enhancing drugs have only been increasing Barroso et al. Despite centuries of reports of using substances to enhance athletic performance, testing athletes for the use of performance-enhancing drugs began only in 1968 Barroso et al.
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