Document Detail


Effect of spironolactone on blood pressure and the renin-angiotensin-aldosterone system in oligo-anuric hemodialysis patients.
MedLine Citation:
PMID:  15983962     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Evan Gross; Marcos Rothstein; Susan Dombek; Henrikas Irmantas Juknis
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
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:
Created Date:  2005-06-28     Completed Date:  2005-11-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  94-101     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Renal Division, Washington University School of Medicine, St Louis, MO, USA.
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MeSH Terms
Descriptor/Qualifier:
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:
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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