In:
Kidney and Blood Pressure Research, S. Karger AG, Vol. 39, No. 6 ( 2014), p. 573-580
Abstract:
〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 This study aimed to investigate the potential beneficial anti-proteinuric effect of an add-on aldosterone blockade and the impact of the aldosterone escape phenomenon. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We retrospectively analyzed data of 304 patients with persistent proteinuria, who were administered spironolactone (25 mg/day) after treatment with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) for 〉 3 months. Patients were divided according to their aldosterone levels during ACEI/ARB treatment into an escape group (plasma aldosterone 〉 80 pg/mL, N=95, 31.5%) and a non-escape group (plasma aldosterone ≤80 pg/mL, N=209, 68.5%) and according to their urine albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 After 12 months, the UACR decreased significantly in patients with 1≤UACR 〈 3.5 g/g Cr, UACR ≥3.5 g/g Cr, and eGFR ≥60 mL/min/1.73 m 〈 sup 〉 2 〈 /sup 〉 , and in the non-escape group. Severe hyperkalemia (K≥7.0 mEq/L) developed in 9 of 137 patients with eGFR 〈 60 mL/min/1.73 m 〈 sup 〉 2 〈 /sup 〉 (6.5%) and in none of the 167 patients with eGFR≥60 mL/min/1.73 m 〈 sup 〉 2 〈 /sup 〉 . 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Proteinuria decreased significantly after add-on spironolactone treatment in patients with 1≤UACR 〈 3.5 g/g Cr, UACR ≥3.5 g/g Cr, and eGFR ≥60 mL/min/1.73 m 〈 sup 〉 2 〈 /sup 〉 , and in the non-escape group. The anti-proteinuric effect of spironolactone may vary according to the degree of albuminuria, impaired eGFR, and aldosterone escape.
Type of Medium:
Online Resource
ISSN:
1420-4096
,
1423-0143
Language:
English
Publisher:
S. Karger AG
Publication Date:
2014
detail.hit.zdb_id:
1482922-8
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