Long-term effects of aldosterone blockade in resistant hypertension associated with chronic kidney disease

  • Pisoni R
  • Acelajado M
  • Cartmill F
 et al. 
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Abstract

Hypertension is a major risk factor for the development and progression of chronic kidney disease (CKD). Mineralocorticoid receptor antagonists (MRAs) are effective in the management of resistant hypertension but are not widely used in CKD because of the risk of hyperkalemia. We retrospectively evaluated the long-term effects and safety of MRAs added to a pre-existing antihypertensive regimen in subjects with resistant hypertension associated with stage 3 CKD. In all, 32 patients were treated with spironolactone and 4 with eplerenone for a median follow-up of 312 days. MRAs induced a significant decrease in systolic blood pressure from 162+/-22 to 138+/-14 mm Hg (P

Author-supplied keywords

  • *Drug Resistance
  • Acute Kidney Injury/blood/chemically induced/physi
  • Aged
  • Alabama
  • Angiotensin II Type 1 Receptor Blockers/therapeuti
  • Angiotensin-Converting Enzyme Inhibitors/therapeut
  • Antihypertensive Agents/adverse effects/*therapeut
  • Biological Markers/blood
  • Blood Pressure/*drug effects
  • Chi-Square Distribution
  • Chronic Disease
  • Creatinine/blood
  • Diuretics/therapeutic use
  • Drug Therapy, Combination
  • Female
  • Glomerular Filtration Rate/drug effects
  • Humans
  • Hyperkalemia/blood/chemically induced
  • Hypertension/complications/*drug therapy/physiopat
  • Kidney Diseases/blood/*complications/physiopatholo
  • Kidney/drug effects/physiopathology
  • Logistic Models
  • Male
  • Middle Aged
  • Mineralocorticoid Receptor Antagonists/adverse eff
  • Potassium/blood
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Spironolactone/adverse effects/*analogs & derivati
  • Time Factors
  • Treatment Outcome

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Authors

  • R Pisoni

  • M C Acelajado

  • F R Cartmill

  • T Dudenbostel

  • L J Dell'Italia

  • S S Cofield

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