NDT Advance Access originally published online on January 31, 2006
Nephrology Dialysis Transplantation 2006 21(4):854-858; doi:10.1093/ndt/gfk086
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Editorial Review
Is it time for spironolactone therapy in dialysis patients?
1 Nephrology Clinic, Parhon University Hospital, Iasi, Romania and 2 Renal Unit, Guy's Hospital, London, UK
Correspondence and offprint requests to: Prof. Dr Adrian Covic, MD, PhD, Nephrology Clinic and Dialysis and Transplantation Center, ‘C. I. Parhon’ University Hospital, Iasi 6600, Romania. Email: acovic@xnet.ro
Keywords: aldosterone; chronic kidney disease; end-stage renal disease; haemodialysis; hyperkalaemia; spironolactone
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Aldosterone in chronic kidney disease |
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Aldosterone has been identified in the last decade as an important contributor to the progression of both kidney and heart disease. In elegant experimental studies, Rocha and co-workers [1] demonstrated that aldosterone is responsible for inflammation and fibrosis in the kidney. According to very recent experimental data, spironolactone may induce a regression of existing glomerulosclerosis [2]. In humans, there are few and small studies confirming the beneficial effect of aldosterone antagonism on proteinuria reduction [3–5]. Thus, aldosterone blockade has the theoretic advantage of addressing both heart and kidney damage, a frequent deadly duo.
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Cardiomyopathy in chronic kidney disease |
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Congestive heart failure (CHF) has been recognized recently as the first cause of cardiovascular death in chronic kidney disease (CKD) [6]. Once established, CHF in dialysis subjects is associated with a catastrophic survival [7]. Moreover, cardiac abnormalities are early (and progressive) events in CKD patients, often precluding
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The RALES lesson |
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Aldosterone and the genesis of uraemic cardiomyopathy |
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The threat of hyperkalaemia in ESRD |
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Aldosterone blockade in HD patients |
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Aldosterone blockade in peritoneal dialysis |
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Perspectives |
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