The Effects of Spironolactone on Nephron Function in Patients with Diabetic Nephropathy

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dc.contributor.authorUstundag, Ayten
dc.contributor.authorTugrul, Armagan
dc.contributor.authorUstundag, Sedat
dc.contributor.authorSut, Necdet
dc.contributor.authorDemirkan, Bora
dc.date.accessioned2024-06-12T10:59:27Z
dc.date.available2024-06-12T10:59:27Z
dc.date.issued2008
dc.departmentTrakya Üniversitesien_US
dc.description.abstractIncreasing evidence suggests that circulating aldosterone per se contributes directly to renal and cardiovascular diseases. We sought to evaluate the effects of a three-month treatment with 25 mg spironolactone, an aldosterone receptor antagonist, on nephron function in 20 type II diabetic patients with persistent microalbuminuria, despite at least six months' use of an ACEi or ARB (combination group), and in eleven type II diabetic patients with persistent microalbuminuria who have never used an ACEi or an ARB (spironolactone group). In the combination group, urinary protein excretion (UPE, p = 0.015), urinary albumin excretion (UAE, p = 0.010), and the urinary albumin to creatinine ratio (ACR, p = 0.007) decreased, and serum potassium (sK+, p = 0.004) was significantly elevated. ACR (p = 0.016) decreased significantly in the spironolactone group. In 31 patients given spironolactone (all patients group), UPE (p = 0.019), UAE (p = 0.002), and ACR (p = 0.011) decreased, and serum creatinine (sCr, p = 0.025) and sK+ (p = 0.002) were significantly elevated. Changes in albuminuria showed a positive correlation with changes in GFR (p = 0.002) and a negative correlation with changes in sCr (p = 0.007), and changes in ACR showed a negative correlation with changes in sCr (p = 0.004) in all patient groups. In our study, we observed that spironolactone, both alone and in combination with ACEi/ARB treatment, was well tolerated, and that it slowed down the progression of diabetic nephropathy with a marked antialbuminuric effect. Our results showed that the antialbuminuric effect developed by the decrease of intraglomerular pressure, particularly in patients with persistent microalbuminuria despite long-term ACEi/ARB treatment; adding aldosterone blockers to treatment was beneficial.en_US
dc.identifier.doi10.1080/08860220802389342
dc.identifier.endpage991en_US
dc.identifier.issn0886-022X
dc.identifier.issn1525-6049
dc.identifier.issue10en_US
dc.identifier.pmid19016150en_US
dc.identifier.scopus2-s2.0-57049133582en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage982en_US
dc.identifier.urihttps://doi.org/10.1080/08860220802389342
dc.identifier.urihttps://hdl.handle.net/20.500.14551/20457
dc.identifier.volume30en_US
dc.identifier.wosWOS:000261019100007en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherTaylor & Francis Ltden_US
dc.relation.ispartofRenal Failureen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectDiabetic Nephropathyen_US
dc.subjectAldosteroneen_US
dc.subjectSpironolactoneen_US
dc.subjectAngiotensin IIen_US
dc.subjectConverting Enzyme-Inhibitoren_US
dc.subjectAngiotensin-Aldosterone Systemen_US
dc.subjectAdding Spironolactoneen_US
dc.subjectBeneficial Impacten_US
dc.subjectBlood-Pressureen_US
dc.subjectProteinuriaen_US
dc.subjectTherapyen_US
dc.subjectAlbuminuriaen_US
dc.subjectReductionen_US
dc.subjectBlockadeen_US
dc.titleThe Effects of Spironolactone on Nephron Function in Patients with Diabetic Nephropathyen_US
dc.typeArticleen_US

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