Document Detail


Effectiveness of eplerenone or spironolactone treatment in preserving renal function in primary aldosteronism.
MedLine Citation:
PMID:  23033260     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Primary aldosteronism (PA) has deleterious effects on kidney function independent of blood pressure levels. Up to now, data on effectiveness of different PA therapies regarding renal function are scarce.
DESIGN AND METHODS: This prospective multi-center study included 29 patients with newly diagnosed PA evaluated before and 1 year after treatment initiation, and a second cohort including 119 patients who were evaluated 5.3 and 6.8 years after treatment initiation. Glomerular filtration rate (GFR), spot urine albumin excretion/urinary creatinine (UAE/Ucrea) ratio, biochemical parameters, and 24-h blood pressure were measured. In a larger cross-sectional cohort, renal function was evaluated depending on the type of treatment (adrenalectomy (ADX; n=86); spironolactone (n=65); and eplerenone (n=18)).
RESULTS: GFR and UAE/Ucrea ratio significantly decreased in newly diagnosed PA patients after treatment initiation. In the second cohort, GFR and UAE/Ucrea ratio did not change during study period, and blood pressure was well controlled. In the larger cross-sectional cohort, no differences were seen in GFR and UAE/Ucrea ratio between PA patients on different treatment regimens. However, eplerenone treatment showed lower potassium levels and higher number of required antihypertensive medications.
CONCLUSIONS: Renal dysfunction with elevated albuminuria was seen in PA patients and was reversible after treatment initiation. Medical therapies with spironolactone or eplerenone seem to be as effective as ADX regarding renal function and blood pressure; however, sufficient daily doses need to be given.
Authors:
Verena Fourkiotis; Oliver Vonend; Sven Diederich; Evelyn Fischer; Katharina Lang; Stephan Endres; Felix Beuschlein; Holger S Willenberg; Lars C Rump; Bruno Allolio; Martin Reincke; Marcus Quinkler;
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2012-12-10
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  168     ISSN:  1479-683X     ISO Abbreviation:  Eur. J. Endocrinol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-11     Completed Date:  2013-02-04     Revised Date:  2013-11-25    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  75-81     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adrenalectomy
Adult
Aged
Aged, 80 and over
Albuminuria / urine
Blood Pressure / drug effects
Creatinine / urine
Female
Glomerular Filtration Rate / drug effects
Humans
Hyperaldosteronism / drug therapy*,  surgery*
Kidney / physiopathology*
Kidney Function Tests
Male
Middle Aged
Prospective Studies
Spironolactone / analogs & derivatives*,  therapeutic use*
Chemical
Reg. No./Substance:
27O7W4T232/Spironolactone; 6995V82D0B/eplerenone; AYI8EX34EU/Creatinine
Comments/Corrections
Comment In:
Eur J Endocrinol. 2013 Jan;168(1):C1-5   [PMID:  23082005 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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