Long-term effects of spironolactone in peritoneal dialysis patients

Journal of the American Society of Nephrology : JASN
Yasuhiko ItoNagoya Spiro Study Group

Abstract

ESRD treated with dialysis is associated with increased left ventricular hypertrophy, which, in turn, is related to high mortality. Mineralocorticoid receptor antagonists improve survival in patients with chronic heart failure; however, the effects in patients undergoing dialysis remain uncertain. We conducted a multicenter, open-label, prospective, randomized trial with 158 patients receiving angiotensin-converting enzyme inhibitor or angiotensin type 1 receptor antagonist and undergoing peritoneal dialysis with and without (control group) spironolactone for 2 years. As a primary endpoint, rate of change in left ventricular mass index assessed by echocardiography improved significantly at 6 (P=0.03), 18 (P=0.004), and 24 (P=0.01) months in patients taking spironolactone compared with the control group. Rate of change in left ventricular ejection fraction improved significantly at 24 weeks with spironolactone compared with nontreatment (P=0.02). The benefits of spironolactone were clear in patients with reduced residual renal function. As secondary endpoints, renal Kt/V and dialysate-to-plasma creatinine ratio did not differ significantly between groups during the observation period. No serious adverse effects, such as hyperkal...Continue Reading

References

Sep 1, 1989·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·N B SchillerI Schnittger
Sep 1, 1985·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·A Spital, R H Sterns
Jan 1, 1982·Nephron·D G OreopoulosS I Vas
Nov 20, 1998·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·R N FoleyM J Sarnak
Oct 29, 2002·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Michael J Hausmann, Noah Liel-Cohen
Apr 2, 2003·The New England Journal of Medicine·Bertram PittUNKNOWN Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study Investigators
May 29, 2004·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Hiromichi SuzukiHidetomo Nakamoto
Aug 6, 2004·The New England Journal of Medicine·David N JuurlinkDonald A Redelmeier
Dec 22, 2004·Kidney International·Graham A StewartAlan G Jardine
Jun 29, 2005·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Cheuk-Chun SzetoPhilip Kam-Tao Li
Feb 2, 2006·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Adrian CovicDavid J A Goldsmith
Jul 4, 2007·Circulation·Ernesto L SchiffrinJohannes F E Mann
Mar 21, 2008·American Journal of Physiology. Renal Physiology·Hayato NishimuraSeiichi Matsuo
Feb 25, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Angela Yee-Moon WangJohn E Sanderson
Mar 6, 2009·Clinical Journal of the American Society of Nephrology : CJASN·Sankar D NavaneethanGiovanni F M Strippoli
Apr 28, 2009·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Jeffrey Perl, Joanne M Bargman
Aug 29, 2009·Clinical Journal of the American Society of Nephrology : CJASN·Rajan K PatelAlan G Jardine
Jan 9, 2010·Clinical Journal of the American Society of Nephrology : CJASN·Richard J GlassockSilvio H Barberato
Jun 23, 2010·Nature Reviews. Nephrology·Raymond T Krediet, Olga Balafa
Nov 16, 2010·The New England Journal of Medicine·Faiez ZannadUNKNOWN EMPHASIS-HF Study Group
Feb 2, 2011·Nature Reviews. Nephrology·M Khaled Shamseddin, Patrick S Parfrey
Mar 18, 2011·Kidney International·Jean-Philippe BertocchioFrederic Jaisser
Mar 27, 2012·Circulation Journal : Official Journal of the Japanese Circulation Society·Kunitsugu TakasakiChuwa Tei
Nov 30, 2012·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Shigeru NakaiYoshiharu Tsubakihara
Feb 8, 2013·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Takahide KohroRyozo Nagai

❮ Previous
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Citations

Aug 6, 2015·Seminars in Dialysis·Samantha Dias Suthar, John P Middleton
Jan 23, 2016·Oxidative Medicine and Cellular Longevity·Julio César Jiménez PérezPaula Cordero Pérez
Aug 19, 2015·Journal of Clinical Pharmacy and Therapeutics·P Ditsawanon, P Aramwit
Oct 13, 2015·The Journal of Clinical Hypertension·Panagiotis I GeorgianosPantelis E Zebekakis
Sep 10, 2014·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Somchai YongsiriPakaphan Dinchuthai
Jun 7, 2016·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Kevin QuachMichael Walsh
Nov 1, 2016·Clinical Journal of the American Society of Nephrology : CJASN·Panagiotis I Georgianos, Rajiv Agarwal
Mar 7, 2017·Seminars in Dialysis·Dana C Miskulin, Daniel E Weiner
Sep 17, 2014·Nature Reviews. Nephrology·Csaba P Kovesdy
Oct 21, 2018·Clinical Journal of the American Society of Nephrology : CJASN·Vasilios VaiosRajiv Agarwal
Jul 4, 2015·Clinical Journal of the American Society of Nephrology : CJASN·Michael WalshRon Wald
Mar 23, 2019·Kidney Research and Clinical Practice·Yong-Lim Kim
Aug 17, 2019·Jornal brasileiro de nefrologia : ʹorgão oficial de Sociedades Brasileira e Latino-Americana de Nefrologia·Ana Paula Santana GueirosAluizio Barbosa de Carvalho
Jun 11, 2016·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Tibor FulopLászló Rosivall
Aug 1, 2015·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Angela Yee Moon WangRoberto Pecoits-Filho
Apr 15, 2020·Seminars in Dialysis·Timothy W R DoultonIndranil Dasgupta
Nov 14, 2018·Jornal brasileiro de nefrologia : ʹorgão oficial de Sociedades Brasileira e Latino-Americana de Nefrologia·Sérgio Gardano Elias BucharlesRoberto Pecoits-Filho
Apr 10, 2020·Clinical Journal of the American Society of Nephrology : CJASN·Adhish Agarwal, Alfred K Cheung
Apr 30, 2017·Current Hypertension Reports·Radmila Lyubarova, Elvira O Gosmanova
Jan 14, 2020·International Journal of Nephrology·Abdullah HamadFadwa Alali
Apr 14, 2020·Expert Opinion on Pharmacotherapy·Takashi MaruyamaMasanori Abe
Apr 4, 2019·Evidence-based Complementary and Alternative Medicine : ECAM·Yan LiMin Liang
Feb 18, 2020·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Chang Huei ChenIsaac Teitelbaum
Oct 8, 2020·Pharmacology & Therapeutics·Cosimo CosimatoThomas A Mavrakanas
Feb 16, 2021·The Cochrane Database of Systematic Reviews·Takeshi HasegawaHisashi Noma
Nov 27, 2018·Kidney International·David M CharytanUNKNOWN Hemodialysis Novel Therapies Consortium
Feb 5, 2019·Kidney International·Fabian HammerUNKNOWN MiREnDa Study Group
Jun 13, 2021·Clinical Journal of the American Society of Nephrology : CJASN·Kuan-Ting ChenChih-Chin Kao

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