PMID- 22569436
OWN - NLM
STAT- MEDLINE
DCOM- 20120626
LR  - 20220311
IS  - 1319-2442 (Print)
IS  - 1319-2442 (Linking)
VI  - 23
IP  - 3
DP  - 2012 May
TI  - A prospective double-blind randomized placebo-controlled clinical trial to 
      evaluate the safety and efficacy of spironolactone in patients with advanced 
      congestive heart failure on continuous ambulatory peritoneal dialysis.
PG  - 507-12
AB  - Congestive heart failure (CHF) is frequent in patients with chronic renal 
      failure, and may contribute to high cardiovascular morbidity and mortality. There 
      is little data in the literature about the safety and efficacy of use of 
      spironolactone in patients with end-stage renal disease with heart failure. In 
      this study, we evaluated the safety and efficacy of spironolactone in patients on 
      continuous ambulatory peritoneal dialysis (CAPD) with CHF. This randomized 
      prospective double-blind placebo-controlled clinical trial was performed at the 
      St. Al-Zahra peritoneal dialysis center. Eighteen CAPD patients with New York 
      Heart Association (NYHA) class III or IV heart failure, ejection fraction (EF) 
      </=45%, serum potassium level </=5.5 mEq/L and who were eligible, were randomly 
      assigned to taking either spironolactone (25 mg every other day) or placebo for 
      six months. The serum potassium was measured monthly and echocardiography was 
      repeated at the end of the study period. The serum potassium levels rose in both 
      groups, and there was no statistically significant difference intragroup and 
      between the groups during the study period. Only in one patient in the 
      spironolactone group did the serum potassium level reach above the critical level 
      (5.70 mEq/L) at the end of the second month of study, necessitating patient 
      exclusion. The EF did not change significantly in the placebo group (33.3 +/- 11.7 
      vs. 34.2 +/- 11.6, F = 1, P = 0.363), but in the spironolactone group the EF rose 
      significantly (25.7 +/- 7.3 vs. 33.3 +/- 7.8, F = 27.45, P = 0.002). Our study 
      suggests that spironolactone could be used in CHF patients on CAPD to improve 
      their cardiac function, but close monitoring of their serum potassium level is 
      required.
FAU - Taheri, Shahram
AU  - Taheri S
AD  - Isfahan Kidney Diseases Research Center/Nephrology Division, Department of 
      Internal Medicine, St. Al-Zahra Hospital, Isfahan, Iran. shah63tah@yahoo.com
FAU - Mortazavi, Mojgan
AU  - Mortazavi M
FAU - Pourmoghadas, Ali
AU  - Pourmoghadas A
FAU - Seyrafian, Shiva
AU  - Seyrafian S
FAU - Alipour, Zeynab
AU  - Alipour Z
FAU - Karimi, Shirin
AU  - Karimi S
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - Saudi Arabia
TA  - Saudi J Kidney Dis Transpl
JT  - Saudi journal of kidney diseases and transplantation : an official publication of 
      the Saudi Center for Organ Transplantation, Saudi Arabia
JID - 9436968
RN  - 0 (Biomarkers)
RN  - 0 (Mineralocorticoid Receptor Antagonists)
RN  - 0 (Placebos)
RN  - 27O7W4T232 (Spironolactone)
RN  - RWP5GA015D (Potassium)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Analysis of Variance
MH  - Biomarkers/blood
MH  - Chi-Square Distribution
MH  - Double-Blind Method
MH  - Drug Monitoring
MH  - Female
MH  - Heart Failure/blood/complications/diagnostic imaging/*drug 
      therapy/physiopathology
MH  - Humans
MH  - Iran
MH  - Kidney Failure, Chronic/blood/complications/*therapy
MH  - Male
MH  - Middle Aged
MH  - Mineralocorticoid Receptor Antagonists/adverse effects/*therapeutic use
MH  - *Peritoneal Dialysis, Continuous Ambulatory
MH  - Placebos
MH  - Potassium/blood
MH  - Prospective Studies
MH  - Recovery of Function
MH  - Spironolactone/adverse effects/*therapeutic use
MH  - Stroke Volume/drug effects
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ultrasonography
EDAT- 2012/05/10 06:00
MHDA- 2012/06/27 06:00
CRDT- 2012/05/10 06:00
PHST- 2012/05/10 06:00 [entrez]
PHST- 2012/05/10 06:00 [pubmed]
PHST- 2012/06/27 06:00 [medline]
AID - SaudiJKidneyDisTranspl_2012_23_3_507_95778 [pii]
PST - ppublish
SO  - Saudi J Kidney Dis Transpl. 2012 May;23(3):507-12.