Moderate antiproteinuric effect of add-on aldosterone blockade with eplerenone in non-diabetic chronic kidney disease. A randomized cross-over study.
Moderate antiproteinuric effect of add-on aldosterone blockade with eplerenone in non-diabetic chronic kidney disease. A randomized cross-over study.
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DOI：
10.1371/journal.pone.0026904
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发表时间：
2011
期刊：
影响因子：
3.7
通讯作者：
Kamper AL
中科院分区：
文献类型：
--
作者：
Boesby L;Elung-Jensen T;Klausen TW;Strandgaard S;Kamper AL
使用肾素-血管紧张素系统 (RAS) 阻滞剂降低蛋白尿和血压 (BP)，可抑制慢性肾脏病 (CKD) 的进展。醛固酮拮抗剂螺内酯具有抗蛋白尿作用，但其使用受到副作用的限制。本研究评估了选择性醛固酮拮抗剂依普利酮在非糖尿病 CKD 中的短期抗蛋白尿作用和安全性。开放随机交叉试验。 40 名非糖尿病 CKD 且尿白蛋白排泄量大于 300 mg/24 小时的患者。八周每日一次，在稳定的标准抗高血压治疗（包括 RAS 阻断）的基础上附加 25-50 mg 依普利农。 24 小时尿白蛋白排泄量、血压、β-钾和肌酐清除率。平均尿白蛋白排泄率为 22% [CI: 14,28]，P<0.001，在依普利农治疗期间较低。平均收缩压为 4 mmHg [CI: 2,6]，P = 0.002，舒张压为 2 mmHg [CI: 0,4]，P = 0.02，肌酐清除率为 5% [CI: 2,8]，P = 0.005，依普利农治疗期间较低。校正研究期间之间的血压和肌酐清除率差异后，平均尿白蛋白排泄率为 14% [CI: 4,24]，治疗期间 P = 0.008 较低。依普利农治疗期间，平均β钾含量升高0.1 mEq/L [CI: 0.1,0.2]，P<0.001。因此，依普利农的耐受性良好，没有患者因高钾血症而退出治疗。开放标签、无洗脱期、样本量适中。在非糖尿病 CKD 患者中，在标准抗高血压治疗（包括 RAS 阻断）中添加依普利农，导致白蛋白尿中度与血压无关的下降、肌酐清除率轻微下降以及 p-钾增加 0.1 mEq/L。临床试验.gov NCT00430924
Reduction of proteinuria and blood pressure (BP) with blockers of the renin-angiotensin system (RAS) impairs the progression of chronic kidney disease (CKD). The aldosterone antagonist spironolactone has an antiproteinuric effect, but its use is limited by side effects. The present study evaluated the short-term antiproteinuric effect and safety of the selective aldosterone antagonist eplerenone in non-diabetic CKD. Open randomized cross-over trial. Forty patients with non-diabetic CKD and urinary albumin excretion greater than 300 mg/24 hours. Eight weeks of once-daily administration of add-on 25–50 mg eplerenone to stable standard antihypertensive treatment including RAS-blockade. 24 hour urinary albumin excretion, BP, p-potassium, and creatinine clearance. The mean urinary albumin excretion was 22% [CI: 14,28], P<0.001, lower during treatment with eplerenone. Mean systolic BP was 4 mmHg [CI: 2,6], P = 0.002, diastolic BP was 2 mmHg [CI: 0,4], P = 0.02, creatinine clearance was 5% [CI: 2,8], P = 0.005, lower during eplerenone treatment. After correction for BP and creatinine clearance differences between the study periods, the mean urinary albumin excretion was 14% [CI: 4,24], P = 0.008 lower during treatment. Mean p-potassium was 0.1 mEq/L [CI: 0.1,0.2] higher during eplerenone treatment, P<0.001. Eplerenone was thus well tolerated and no patients were withdrawn due to hyperkalaemia. Open label, no wash-out period and a moderate sample size. In non-diabetic CKD patients, the addition of eplerenone to standard antihypertensive treatment including RAS-blockade caused a moderate BP independent fall in albuminuria, a minor fall in creatinine clearance and a 0.1 mEq/L increase in p-potassium. Clinicaltrials.gov NCT00430924
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影响因子：
19.6
作者：
Ruggenenti, P;Perna, A;Remuzzi, G
通讯作者：
Remuzzi, G
影响因子：
4.8
作者：
Michea, L;Delpiano, AM;Marusic, ET
通讯作者：
Marusic, ET
DOI：
10.1016/j.jsbmb.2006.09.018
发表时间：
2006-12-01
影响因子：
4.1
作者：
Arima, Shuji
通讯作者：
Arima, Shuji
影响因子：
4.1
作者：
Rudolph, AE;Rocha, R;McMahon, EG
通讯作者：
McMahon, EG
DOI：
10.2215/cjn.01110905
发表时间：
2006-07-01
影响因子：
9.8
作者：
Kanno, Yoshihiko;Takenaka, Tsuneo;Suzuki, Hiromichi
通讯作者：
Suzuki, Hiromichi