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Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study

INTRODUCTION: There is evidence that aldosterone plays a role in the pathogenesis of vascular calcification. The aim of this study was to evaluate the effect of spironolactone, a mineralocorticoid receptor antagonist, on the progression of coronary calcification (CC) in peritoneal dialysis patients...

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Autores principales: Gueiros, Ana Paula Santana, Gueiros, José Edevanilson de Barros, Nóbrega, Karina Tavares, Calado, Eveline Barros, da Matta, Marina Cadena, Torres, Leuridan Cavalcante, Souza, Alex Sandro Rolland, Casarini, Dulce Elena, de Carvalho, Aluizio Barbosa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Nefrologia 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6788848/
https://www.ncbi.nlm.nih.gov/pubmed/31419271
http://dx.doi.org/10.1590/2175-8239-JBN-2019-0009
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author Gueiros, Ana Paula Santana
Gueiros, José Edevanilson de Barros
Nóbrega, Karina Tavares
Calado, Eveline Barros
da Matta, Marina Cadena
Torres, Leuridan Cavalcante
Souza, Alex Sandro Rolland
Casarini, Dulce Elena
de Carvalho, Aluizio Barbosa
author_facet Gueiros, Ana Paula Santana
Gueiros, José Edevanilson de Barros
Nóbrega, Karina Tavares
Calado, Eveline Barros
da Matta, Marina Cadena
Torres, Leuridan Cavalcante
Souza, Alex Sandro Rolland
Casarini, Dulce Elena
de Carvalho, Aluizio Barbosa
author_sort Gueiros, Ana Paula Santana
collection PubMed
description INTRODUCTION: There is evidence that aldosterone plays a role in the pathogenesis of vascular calcification. The aim of this study was to evaluate the effect of spironolactone, a mineralocorticoid receptor antagonist, on the progression of coronary calcification (CC) in peritoneal dialysis patients and to identify the factors involved in this progression. METHODS: Thirty-three patients with a coronary calcium score (CCS) ≥ 30, detected through multi-detector computed tomography (MDCT) and expressed in Agatston units, were randomly assigned to a group receiving 25mg spironolactone per day for 12 months (spironolactone group) and a control group not receiving this drug. The primary outcome was a percentage change in CCS from baseline to end of the study (relative progression), when a further MDCT was conducted. Patients who had progression of CC were compared with those who did not progress. RESULTS: Sixteen patients, seven in the spironolactone group and nine in the control group, concluded the study. The relative progression of the CCS was similar in both groups, 17.2% and 27.5% in the spironolactone and control groups respectively. Fifty-seven percent of the treated patients and 67% of those in the control group presented progression in the CC scores (p = 0.697). Progressor patients differed from non-progressors because they presented higher levels of calcium and low-density lipoprotein cholesterol and lower levels of albumin. CONCLUSION: In peritoneal dialysis patients, spironolactone did not attenuate the progression of CC. However, large-scale studies are needed to confirm this observation. Disorders of mineral metabolism and dyslipidemia are involved in the progression of CC.
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spelling pubmed-67888482019-10-23 Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study Gueiros, Ana Paula Santana Gueiros, José Edevanilson de Barros Nóbrega, Karina Tavares Calado, Eveline Barros da Matta, Marina Cadena Torres, Leuridan Cavalcante Souza, Alex Sandro Rolland Casarini, Dulce Elena de Carvalho, Aluizio Barbosa J Bras Nefrol Original Articles INTRODUCTION: There is evidence that aldosterone plays a role in the pathogenesis of vascular calcification. The aim of this study was to evaluate the effect of spironolactone, a mineralocorticoid receptor antagonist, on the progression of coronary calcification (CC) in peritoneal dialysis patients and to identify the factors involved in this progression. METHODS: Thirty-three patients with a coronary calcium score (CCS) ≥ 30, detected through multi-detector computed tomography (MDCT) and expressed in Agatston units, were randomly assigned to a group receiving 25mg spironolactone per day for 12 months (spironolactone group) and a control group not receiving this drug. The primary outcome was a percentage change in CCS from baseline to end of the study (relative progression), when a further MDCT was conducted. Patients who had progression of CC were compared with those who did not progress. RESULTS: Sixteen patients, seven in the spironolactone group and nine in the control group, concluded the study. The relative progression of the CCS was similar in both groups, 17.2% and 27.5% in the spironolactone and control groups respectively. Fifty-seven percent of the treated patients and 67% of those in the control group presented progression in the CC scores (p = 0.697). Progressor patients differed from non-progressors because they presented higher levels of calcium and low-density lipoprotein cholesterol and lower levels of albumin. CONCLUSION: In peritoneal dialysis patients, spironolactone did not attenuate the progression of CC. However, large-scale studies are needed to confirm this observation. Disorders of mineral metabolism and dyslipidemia are involved in the progression of CC. Sociedade Brasileira de Nefrologia 2019-08-15 2019 /pmc/articles/PMC6788848/ /pubmed/31419271 http://dx.doi.org/10.1590/2175-8239-JBN-2019-0009 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Gueiros, Ana Paula Santana
Gueiros, José Edevanilson de Barros
Nóbrega, Karina Tavares
Calado, Eveline Barros
da Matta, Marina Cadena
Torres, Leuridan Cavalcante
Souza, Alex Sandro Rolland
Casarini, Dulce Elena
de Carvalho, Aluizio Barbosa
Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study
title Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study
title_full Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study
title_fullStr Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study
title_full_unstemmed Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study
title_short Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study
title_sort effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6788848/
https://www.ncbi.nlm.nih.gov/pubmed/31419271
http://dx.doi.org/10.1590/2175-8239-JBN-2019-0009
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