Our randomized, double-masked cross-over study of type 2 diabetic patients with nephropathy in whom an ACE inhibitor and/or an ARB were titrated to the recommended maximum doses demonstrates that addition of a low dose of spironolactone provides additional reno- and cardiovascular protection, as reflected by substantial short-term reductions in albuminuria and arterial blood pressure. In the present prospective randomized open-label study, we evaluated the effects of spironolactone (25 mg/day for 1 year) on proteinuria and estimated glomerular filtration rate in 83 patients with chronic kidney disease already treated with angiotensin-converting enzyme inhibitors and/or angiotensin type 1 receptor antagonists. Inhibitors of the renin–angiotensin–aldosterone (RAAS) system are cornerstones of the management of patients with heart failure with reduced left ventricular ejection fraction (HFrEF). However, by the end of 1 year the monthly rate of decrease in estimated glomerular filtration rate from baseline was lower in patients treated with spironolactone than in controls (0.323±0.044 vs 0.474±0.037 ml/min/1.73 m 2 , P <0.01). By continuing you agree to the Copyright © 2020 Elsevier B.V. or its licensors or contributors. ScienceDirect ® is a registered trademark of Elsevier B.V.Long-term effects of spironolactone on proteinuria and kidney function in patients with chronic kidney diseaseCopyright © 2006 International Society of Nephrology. Spironolactone, sold under the brand name Aldactone among others, is a medication that is primarily used to treat fluid build-up due to heart failure, liver scarring, or kidney disease. H�bd`ab`dd�swq����M������!��#�C��8�9���w�����U��a���� 0. 0 comment. Hence, administration of aldosterone receptor antagonists may provide additional renal protection. �Cq�]M`dr�Z��[I �l琷��&������nڗ�B}��:�0�s\�!�8R����>��M6)a�u�8�4De����+�}����=r�_Mw�-)}ㄔ������͛M�vB�;�^��ד0��5!\�|����9Y�liDe*�̫T���? ... Of course if the dose is too much for you it can cause low BP and very lo ... Read More. As a major modifiable risk factor for cardiovascular disease in this high-risk population, treatment of hypertension in CKD is important. }����-+�Ԉ���m��u��o���fISPbl�cG)&j;�G� ��o)

Eighty-two patients were treated with angiotensin-converting enzyme inhibitors and/or angiotensin type 1 receptor antagonists alone and served as controls. Published by Elsevier Inc. All rights reserved.ScienceDirect ® is a registered trademark of Elsevier B.V. 3.

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%PDF-1.4 %���� CONCLUSIONS. H�\��j�0��~ However, RAAS inhibitors may cause decline in renal function and/or hyperkalaemia, particularly during initiation and titration, intercurrent illness and during worsening of heart failure. Top answers from doctors based on your search: Disclaimer. H�,N�K�@�i��VE!t����Z\�P��ZP�FW!6W �M�D!Ut)R*. endstream endobj 12 0 obj<> endobj 13 0 obj<>stream 2 doctors agree. Monitor electrolytes—discontinue if hyperkalaemia occurs (in severe heart failure monitor potassium and creatinine 1 week after initiation and after any dose increase, monthly for first 3 months, then every 3 months for 1 year, and then every 6 months). endstream endobj 14 0 obj<>/ProcSet[/PDF/Text]/ExtGState<>>>/Type/Page>> endobj 16 0 obj<>stream ]ܜ\��"��8vtp����;�ｏ�x(��%B��[+k�Lq�0��皁=��m�*�Sl���&R���'�軑�#�r����}�� ���0��|>���fs˶���� W}(���{� ���eׅ��P�>&'��o8>X@��#����U��WU¬Y���,v�:�Xe���3��al\I���C�k^G�+B���k�5{�qS�7�M�z���*��S)��{����*{�%�R �=��;���>�Z��y��KIA�M�j�g�^�Ï:*}j�W-�}�;���Ju%�0 ݟ'
After 1 month of therapy with spironolactone, estimated glomerular filtration rate decreased more in patients treated with spironolactone than in controls. CKD is common and frequently complicated with hypertension both predialysis and in ESKD.
After 1 year of therapy, proteinuria decreased from 2.1±0.08 to 0.89±0.06 g/g creatinine (We use cookies to help provide and enhance our service and tailor content and ads.

Angiotensin-converting enzyme inhibitors and angiotensin type 1 receptor antagonists suppress the renin–angiotensin system but they do not effectively reduce plasma aldosterone. 1 0 obj<>/ProcSet[/PDF/Text]/ExtGState<>>>/Type/Page>> endobj 3 0 obj<>/ProcSet[/PDF/Text]/ExtGState<>>>/Type/Page>> endobj 5 0 obj<>/ProcSet[/PDF/Text]/ExtGState<>>>/Type/Page>> endobj 7 0 obj<>/ProcSet[/PDF/Text]/ExtGState<>>>/Type/Page>> endobj 9 0 obj<>/ProcSet[/PDF/Text]/ExtGState<>>>/Type/Page>> endobj 11 0 obj<>stream

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