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Spironolactone esrd

Keiko Hosohata, Ayaka Inada, Saki Oyama, Daisuke Furushima, Hiroshi Yamada, Kazunori Iwanaga
WHAT IS KNOWN AND OBJECTIVE: Acute kidney injury (AKI) often occurs in hospitalized patients, and it is an increasing problem worldwide. Recently, clinical studies have shown that there is a strong association between drug-induced AKI and poor outcomes, including the progression of chronic kidney disease and end-stage renal disease; however, limited data are available on drug-induced AKI. The purpose of this study was to clarify the rank-order of the association of all drugs with AKI using a spontaneous reporting system database...
July 16, 2018: Journal of Clinical Pharmacy and Therapeutics
Panagiotis I Georgianos, Vasilios Vaios, Theodoros Eleftheriadis, Pantelis Zebekakis, Vassilios Liakopoulos
BACKGROUND: Add-on therapy with the Mineralocorticoid-Receptor-Antagonists (MRAs) spironolactone and eplerenone was shown to enhance the cardioprotective action of angiotensinconverting- enzyme-inhibitors (ACEIs), angiotensin-receptor-blockers (ARBs) and/or β-blockers in nondialysis patients with congestive heart failure (CHF) and reduced left ventricular (LV) ejection fraction. The risk/benefit ratio of MRAs in dialysis patients is less well defined, owing to concerns that their cardioprotective actions may be counteracted by excess risk of hyperkalemia...
2017: Current Vascular Pharmacology
Tibor Fülöp, Lajos Zsom, Betzaida Rodríguez, Sabahat Afshan, Jamie V Davidson, Tibor Szarvas, Mehul P Dixit, Mihály B Tapolyai, László Rosivall
♦ BACKGROUND: Hypokalemia is a vexing problem in end-stage renal disease patients on peritoneal dialysis (PD), and oral potassium supplements (OPS) have limited palatability. Potassium-sparing diuretics (KSD) (spironolactone, amiloride) may be effective in these patients. ♦ METHODS: We performed a cross-sectional review of 75 current or past (vintage > 6 months) PD patients with regard to serum potassium (K+), OPS, and KSD utilization. We reviewed charts for multiple clinical and laboratory variables, including dialysis adequacy, residual renal function, nutritional status and co-existing medical therapy...
January 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Andrew S Bomback
Mineralocorticoid receptor antagonists (MRAs) that block aldosterone's effects on both epithelial and non-epithelial receptors have become a mainstay of therapy for chronic heart failure. Given that cardiovascular events remain the leading cause of death for patients with end-stage renal disease (ESRD), the question of whether these MRAs can be employed in dialysis patients arises. This review summarizes the rationale for blocking aldosterone in patients with chronic and end-stage kidney disease and surveys the data on both the efficacy and safety of using MRAs in the ESRD population...
2016: Blood Purification
Panagiotis I Georgianos, Pantelis A Sarafidis, Vassilios Liakopoulos, Elias V Balaskas, Pantelis E Zebekakis
No abstract text is available yet for this article.
March 2016: Journal of Clinical Hypertension
Songyan Wang, Bing Li, Chunguang Li, Wenpeng Cui, Lining Miao
Diabetic nephropathy (DN) is the leading cause of end-stage renal disease (ESRD). The development and progression of DN might involve multiple factors. Connective tissue growth factor (CCN2, originally known as CTGF) is the one which plays a pivotal role. Therefore, increasing attention is being paid to CCN2 as a potential therapeutic target for DN. Up to date, there are also many drugs or agents which have been shown for their protective effects against DN via different mechanisms. In this review, we only focus on the potential renoprotective therapeutic agents which can specifically abolish CCN2 expression or nonspecifically inhibit CCN2 expression for retarding the development and progression of DN...
2015: Journal of Diabetes Research
Yi-Wei Chung, Yao-Hsu Yang, Cho-Kai Wu, Chih-Chieh Yu, Jyh-Ming Jimmy Juang, Yi-Chih Wang, Chia-Ti Tsai, Lian-Yu Lin, Ling-Ping Lai, Juey-Jen Hwang, Fu-Tien Chiang, Pau-Chung Chen, Jiunn-Lee Lin
OBJECTIVES: Whether the spironolactone treatment remains effective for the prevention of atrial fibrillation (AF) in dialysis patients is unclear. METHODS: We used a database from the Registry for Catastrophic Illness from the National Health Research Institute. All dialysis patients aged 18 or older without history of AF before ESRD were incorporated. A total of 113,191 dialysis patients were enrolled in the study. The median follow-up time was 4.17 years. We collected information on prescribed drug dosage, number of days of treatment and the total number of pills dispensed from the outpatient pharmacy prescription database...
January 1, 2016: International Journal of Cardiology
ChongTing Lin, Qing Zhang, HuiFang Zhang, AiXia Lin
The purpose of this 2-year multicentric, randomized, placebo-controlled study was to evaluate the long-term effects and adverse effects of spironolactone on chronic dialysis patients. A total of 253 non-heart failure dialysis patients with end-stage renal disease were randomly assigned to 2-year treatment with spironolactone (25 mg once daily, n=125) or a matching placebo (n=128) as add-on therapy. The primary outcome was a composite of death from cardiocerebrovascular (CCV) events, aborted cardiac arrest, and sudden cardiac death, and the secondary outcome was death from all causes...
February 2016: Journal of Clinical Hypertension
Jamie S Hirsch, Yelena Drexler, Andrew S Bomback
Although blockade of the renin-angiotensin-aldosterone system with angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers has become standard therapy for chronic kidney disease (CKD), renewed interest in the role of aldosterone in mediating the injuries and progressive insults of CKD has highlighted the potential role of treatments targeting the mineralocorticoid receptor (MR). Although salt restriction is an important component of mitigating the profibrotic effects of MR activation, a growing body of literature has shown that MR antagonists, spironolactone and eplerenone, can reduce proteinuria and blood pressure in patients at all stages of CKD...
May 2014: Seminars in Nephrology
Atieh Makhlough, Zahra Kashi, Ozra Akha, Ehsan Zaboli, Jamshid Yazdanicharati
BACKGROUND: Diabetic nephropathy is the most important cause of end stage renal disease (ESRD). Aldosterone is involved in renal damage through induction of fibrosis, inflammation and necrosis in the kidney tissue. Previous studies have demonstrated that the combination of angiotensin receptor blocker (ARB) and spironolactone (an anti-aldosterone drug) are efficient for albuminuria reduction. OBJECTIVES: This study was designed to evaluate the effect of spironolactone alone on diabetic nephropathy...
January 2014: Nephro-urology Monthly
Hyun Hee Na, Kyung Jun Park, Sun Young Kim, Haeng Il Koh
A 52-year-old woman was referred to our hospital due to chronic renal failure with a 10-year history of hypertension. We found polycystic kidney disease, pulmonary tuberculosis and an aldosterone-producing adrenocortical mass. At this time, her serum potassium level and blood pressure were within the normal range. She refused hemodialysis and then was hospitalized because of uremic encephalopathy. On admission, her serum potassium level was normal without treatment and plasma aldosterone concentration highly elevated...
November 2006: Electrolyte & Blood Pressure: E & BP
Yasuhiko Ito, Masashi Mizuno, Yasuhiro Suzuki, Hirofumi Tamai, Takeyuki Hiramatsu, Hiroshige Ohashi, Isao Ito, Hirotake Kasuga, Masanobu Horie, Shoichi Maruyama, Yukio Yuzawa, Tatsuaki Matsubara, Seiichi Matsuo
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...
May 2014: Journal of the American Society of Nephrology: JASN
Bertram Pitt, Patrick Rossignol
No abstract text is available yet for this article.
February 18, 2014: Journal of the American College of Cardiology
Fabian Hammer, Vera Krane, Stefan Störk, Christoph Röser, Kirsten Hofmann, Nils Pollak, Bruno Allolio, Christoph Wanner
BACKGROUND: End-stage renal disease (ESRD) patients exhibit an extraordinarily high annual mortality secondary to cardiac and vascular causes, particularly sudden cardiac death (SCD). Left ventricular (LV) hypertrophy is a frequent finding and constitutes an independent predictor of mortality risk in these patients. Mineralocorticoid receptor antagonists (MRAs) are cardioprotective in heart failure patients and effectively reduce LV mass, but are considered inappropriate in patients with severe renal impairment, given their potential to cause hyperkalaemia...
February 2014: Nephrology, Dialysis, Transplantation
Sarah Sanghavi, Susan Whiting, Jaime Uribarri
The advent of dialytic therapy has enabled nephrologists to provide life-saving therapy, but potassium balance continues to be an ever present challenge in the ESRD population. Although a small percent of patients are chronically hypokalemic, hyperkalemia is by far the most common abnormality in dialysis patients. It is associated with increased all-cause mortality, cardiovascular mortality, and arrhythmogenic death. Although alterations of the dialysis bath may decrease predialysis potassium, potassium baths <2 mEq/l are associated with a higher risk of sudden cardiac death...
September 2013: Seminars in Dialysis
Jakob Voelkl, Ioana Alesutan, Christina B Leibrock, Leticia Quintanilla-Martinez, Volker Kuhn, Martina Feger, Sobuj Mia, Mohamed S E Ahmed, Kevin P Rosenblatt, Makoto Kuro-O, Florian Lang
Klotho is a potent regulator of 1,25-hydroxyvitamin D3 [1,25(OH)2D3] formation and calcium-phosphate metabolism. Klotho-hypomorphic mice (kl/kl mice) suffer from severe growth deficits, rapid aging, hyperphosphatemia, hyperaldosteronism, and extensive vascular and soft tissue calcification. Sequelae of klotho deficiency are similar to those of end-stage renal disease. We show here that the mineralocorticoid receptor antagonist spironolactone reduced vascular and soft tissue calcification and increased the life span of kl/kl mice, without significant effects on 1,25(OH)2D3, FGF23, calcium, and phosphate plasma concentrations...
February 2013: Journal of Clinical Investigation
Sanjiv J Shah, John F Heitner, Nancy K Sweitzer, Inder S Anand, Hae-Young Kim, Brian Harty, Robin Boineau, Nadine Clausell, Akshay S Desai, Rafael Diaz, Jerome L Fleg, Ivan Gordeev, Eldrin F Lewis, Valetin Markov, Eileen O'Meara, Bondo Kobulia, Tamaz Shaburishvili, Scott D Solomon, Bertram Pitt, Marc A Pfeffer, Rebecca Li
BACKGROUND: Treatment of Preserved Cardiac Function with an Aldosterone Antagonist (TOPCAT) is an ongoing randomized controlled trial of spironolactone versus placebo for heart failure with preserved ejection fraction (HFpEF). We sought to describe the baseline clinical characteristics of subjects enrolled in TOPCAT relative to other contemporary observational studies and randomized clinical trials of HFpEF. METHODS AND RESULTS: Between August 2006 and January 2012, 3445 patients with symptomatic HFpEF from 270 sites in 6 countries were enrolled in TOPCAT...
March 2013: Circulation. Heart Failure
William L Baker, William B White
OBJECTIVE: To evaluate the literature supporting the safe use of mineralocorticoid antagonists (MRAs) in patients with end-stage renal disease who are receiving hemodialysis. DATA SOURCES: A review of the literature was performed using MEDLINE (1950 through week 2 of February 2012) using the key words and MeSH terms mineralocorticoid antagonists, aldosterone antagonists, spironolactone, or eplerenone combined with dialysis, renal disease, or kidney disease. STUDY SELECTION AND DATA EXTRACTION: Studies eligible for inclusion evaluated the impact of MRAs on serum potassium levels in patients with end-stage renal disease receiving hemodialysis...
June 2012: Annals of Pharmacotherapy
Shahram Taheri, Mojgan Mortazavi, Ali Pourmoghadas, Shiva Seyrafian, Zeynab Alipour, Shirin Karimi
Congestive heart failure (CHF) is frequent in patients with chronic renal failure, and may contribute to high cardiovascular morbidity and mortality. There is little data in the literature about the safety and efficacy of use of spironolactone in patients with end-stage renal disease with heart failure. In this study, we evaluated the safety and efficacy of spironolactone in patients on continuous ambulatory peritoneal dialysis (CAPD) with CHF. This randomized prospective double-blind placebo-controlled clinical trial was performed at the St...
May 2012: Saudi Journal of Kidney Diseases and Transplantation
M Suppa, G Giancaspro, A Coppola, M Colzi, M E Marini, E Magnanelli, E Baldini, F Cavicchi, C Petroni, E Contu, C Boccardo, M G Scarpellini
UNLABELLED: Digoxin is typically prescribed in the treatment of heart failure. Its limited therapeutic range requires systematic monitoring of plasmatic concentration through immunoreactive tests. Laboratory results, however, can be altered by the presence of digoxin-like immunoreactive factors (DLIF) which are released in all clinical conditions involving volemic expansion. CASE REPORT: An 86-year-old woman arrived in emergency with severe dyspnoea, atrial flutter and a medical history of ischemic cardiopathy...
2011: La Clinica Terapeutica
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