| Effect of spironolactone on blood pressure and the renin-angiotensin-aldosterone system in oligo-anuric hemodialysis patients. | |
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MedLine Citation:
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PMID: 15983962 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Through its actions on nonepithelial tissues, including brain, blood vessels, and heart, aldosterone may mediate hypertension, cardiac hypertrophy, and fibrosis. Whether aldosterone has a direct pathogenic role in the development of cardiovascular complications in patients with end-stage renal disease is unknown. Oligo-anuric dialysis patients provide a clinical setting to study the effects of the mineralocorticoid receptor blocker spironolactone that are independent of the diuretic properties of the drug. We performed a randomized, double-blinded, placebo-controlled, crossover study to assess the effect of spironolactone on blood pressure and the renin-angiotensin-aldosterone system in oligo-anuric hemodialysis patients. METHODS: Eight hemodialysis patients were administered either spironolactone, 50 mg, or placebo orally twice daily for 2 weeks, followed by a 3-week washout period, after which patients crossed over in their treatment arms for 2 more weeks. RESULTS: Administration of spironolactone for 2 weeks decreased predialysis systolic blood pressure from 142.0 +/- 19.6 to 131.4 +/- 18.2 mm Hg (P < 0.05). Compared with placebo, a 2-week course of spironolactone had no effect on predialysis and postdialysis plasma potassium or aldosterone concentrations or renin activity. CONCLUSION: When administered for 2 weeks, spironolactone, 50 mg twice daily, reduced predialysis systolic blood pressure, but did not produce hyperkalemia in oligo-anuric hemodialysis patients. |
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Authors:
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Evan Gross; Marcos Rothstein; Susan Dombek; Henrikas Irmantas Juknis |
Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: American journal of kidney diseases : the official journal of the National Kidney Foundation Volume: 46 ISSN: 1523-6838 ISO Abbreviation: Am. J. Kidney Dis. Publication Date: 2005 Jul |
Date Detail:
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Created Date: 2005-06-28 Completed Date: 2005-11-03 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8110075 Medline TA: Am J Kidney Dis Country: United States |
Other Details:
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Languages: eng Pagination: 94-101 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Renal Division, Washington University School of Medicine, St Louis, MO, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aldosterone / blood, secretion* Aldosterone Antagonists / adverse effects, pharmacology, therapeutic use* Antihypertensive Agents / adverse effects, pharmacology, therapeutic use* Anuria / drug therapy*, etiology Blood Pressure / drug effects* Body Weight Cross-Over Studies Double-Blind Method Female Humans Hypertension / complications, drug therapy* Kidney Failure, Chronic / blood, complications, drug therapy*, therapy Male Middle Aged Oliguria / drug therapy*, etiology Potassium / blood Renal Dialysis* Renin-Angiotensin System / drug effects* Spironolactone / adverse effects, pharmacology, therapeutic use* Weight Gain |
| Chemical | |
Reg. No./Substance:
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0/Aldosterone Antagonists; 0/Antihypertensive Agents; 52-01-7/Spironolactone; 52-39-1/Aldosterone; 7440-09-7/Potassium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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