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Effectiveness of eplerenone or spironolactone treatment in preserving renal function in primary aldosteronism.

Abstract：

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.

journal_name

Eur J Endocrinol

journal_title

European journal of endocrinology

authors

Fourkiotis V,Vonend O,Diederich S,Fischer E,Lang K,Endres S,Beuschlein F,Willenberg HS,Rump LC,Allolio B,Reincke M,Quinkler M,Mephisto Study Group.

doi

10.1530/EJE-12-0631

subject

Has Abstract

pub_date

2012-12-10 00:00:00

pages

75-81

issue

1

eissn

0804-4643

issn

1479-683X

pii

EJE-12-0631

journal_volume

168

pub_type

临床试验,杂志文章,多中心研究

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