Volume 5, Issue 4 (volume 5, number 4 2013)                   IJDO 2013, 5(4): 144-150 | Back to browse issues page

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Najafi F, Rezvaninejad B S, Mohammadi S M. The Effects of Adding Spironolactone to ACEI or ARB on Proteinuria in Type 2 Diabetes. IJDO 2013; 5 (4) :144-150
URL: http://ijdo.ssu.ac.ir/article-1-163-en.html
Resident of internal medicine, Division of Nephrology, Department of Internal Medicine, Shaheed Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
Abstract:   (4146 Views)
Abstract Objectives: Interruption of rennin-angiotensin-aldosterone system has become a leading therapeutic strategy in the treatment of diabetic nephropathy however, ACEIs and ARBs do not uniformly suppress the rennin-angiotensin-aldosterone system. Plasma aldosterone levels are elevated in a group of patients despite therapy and this phenomenon known as aldosterone escape or aldosterone break through. Materials and Methods: Forty-two type 2 diabetic patients with overt proteinuria were randomized into two groups and according to double-blind case-control study, one group was treated with spironolactone and others were treated with placebo for 4 months. Twenty-four hours urine protein, glomerular filtration rate (GFR) and blood pressure were measured at baseline and after 4 months of treatment. Serum potassium was checked at baseline and one month of treatment. Results: Urine protein decreased in case group by 26.5% at the end of 4 months, but increased in control group by 17.9% (P=0.003). GFR did not have any significant change in case group (P<0.354), but decreased in case group significantly (P<0.001). Conclusion: Our study showed that spironolactone 12.5 mg/day is safe (without hyperkalemia and gynecomastia) and effective to decrease proteinuria in diabetic patient with CKD1-2.
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Type of Study: Research | Subject: Special
Received: 2014/10/4 | Accepted: 2014/10/4 | Published: 2014/10/4

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