Serum aldosterone levels in hemodialysis patients: A systematic review

Abstract

Background: According to the data provided by the Brazilian Nephrology Society, between the years 2000 and 2011 the number of dialysis patients gradually increased. It is known aldosterone levels contribute to the onset of hypertension given the fact it is related to the increase in sodium absorption with a resultant increase of volemia. The aim of this study was to perform a systematic review regarding the relation between aldosterone levels and hemodialysis. Methods: A review was performed, based on the articles provided by databases Lilacs and Medline, with the descriptors "aldosterone" AND "hemodialysis" until the year 2014. Those articles with the descriptors in their titles or abstracts, or that evaluated the relation between aldosterone and hemodialysis in trials with humans were included. Findings: About 14 articles were excluded and 15 were included. Among the included articles, one was epidemiologic, five were clinical trials, two were prospective cohorts and seven were reviews. Conclusion: It was observed that aldosterone blockade in hemodialysis patients represents an important and safe therapeutic strategy owing to the consequent proteinuria and blood pressure reduction. These factors help reduce cardiovascular risk. Moreover, this strategy contributes to decrease renal injury, suggesting a beneficial effect on the prevention of chronic kidney disease.