Heart Failure and Chronic Kidney Disease: Should We Use Spironolactone?

American Journal of the Medical Sciences

Volumn 350, Issue 2, 2015, Pages 147-151

  Agrawal, Sahil ^a   Agrawal, Nikhil ^b   Garg, Jalaj ^c,d   Mohandas, Rajesh ^e   Gupta, Tanush ^f   Segal, Mark ^e  

^a ST LUKE S UNIVERSITY HEALTH NETWORK   (United States)

^b LEHIGH VALLEY HOSPITAL   (United States)

^c Lehigh Valley Health Network   (United States)

^d UNIVERSITY OF FLORIDA   (United States)

^e UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE   (United States)

^f NEW YORK MEDICAL COLLEGE   (United States)

Author keywords

Aldosterone antagonism; Chronic Kidney Disease; Heart failure; Renal failure; Spironolactone

Indexed keywords

ALDOSTERONE; PLACEBO; POTASSIUM; SPIRONOLACTONE; DIURETIC AGENT;

ADVERSE OUTCOME; ANURIA; CHRONIC KIDNEY DISEASE; CHRONIC KIDNEY FAILURE; DRUG MEGADOSE; HEART FAILURE; HUMAN; HYPERKALEMIA; KIDNEY DYSFUNCTION; OLIGOANURIA; RANDOMIZED CONTROLLED TRIAL (TOPIC); RENIN ANGIOTENSIN ALDOSTERONE SYSTEM; REVIEW; BLOOD; COMPLICATION; DRUG EFFECTS; KIDNEY FAILURE, CHRONIC;

DIURETICS; HEART FAILURE; HUMANS; KIDNEY FAILURE, CHRONIC; POTASSIUM; RENIN-ANGIOTENSIN SYSTEM; SPIRONOLACTONE;

EID: 84938692793     PISSN: 00029629     EISSN: 15382990     Source Type: Journal    
DOI: 10.1097/MAJ.0000000000000514     Document Type: Review

References (67)

1. Foley RN, Parfrey PS, Sarnak MJ. Epidemiology of cardiovascular disease in chronic renal disease. J Am Soc Nephrol 1998;9(12 suppl): S16-23.
2. Foley RN, Murray AM, Li S, et al. Chronic kidney disease and the risk for cardiovascular disease, renal replacement, and death in the United States Medicare population, 1998 to 1999. J Am Soc Nephrol 2005;16:489-95.
3. Parfrey PS, Harnett JD, Foley RN. Heart failure and ischemic heart disease in chronic uremia. Curr Opin Nephrol Hypertens 1995;4:105-10.
4. Struthers AD, MacDonald TM. Review of aldosterone and angiotensin II induced target organ damage and prevention. Cardiovasc Res 2004;61:663-70.
5. Barr CS, Lang CC, Hanson J, et al. Effects of adding spironolactone to an angiotensin-converting enzyme inhibitor in chronic congestive heart failure secondary to coronary artery disease. Am J Cardiol 1995;76:1259-65.
6. MacFadyen RJ, Barr CS, Struthers AD. Aldosterone blockade reduces vascular collagen turnover, improves heart rate variability and reduces early morning rise in heart rate in heart failure patients. Cardiovasc Res 1997;35:30-4.
7. Wang W. Chronic administration of aldosterone depresses baroreceptor reflex function in the dog. Hypertension 1994;24:571-5.
8. Duprez DA, De Buyzere ML, Rietzschel ER, et al. Inverse relationship between aldosterone and large artery compliance in chronically treated heart failure patients. Eur Heart J 1998;19:1371-6.
9. Rocha R, Chander PN, Khanna K, et al. Mineralocorticoid blockade reduces vascular injury in stroke-prone hypertensive rats. Hypertension 1998;31:451-8.
10. Epstein M. Aldosterone as a determinant of cardiovascular and renal dysfunction. J R Soc Med 2001;94:378-83.
11. Brewster UC, Setaro JF, Perazella MA. The renin-angiotensinaldosterone system: cardiorenal effects and implications for renal and cardiovascular disease states. Am J Med Sci 2003;326:15-24.
12. Swedberg K, Eneroth P, Kjekshus J, et al. Hormones regulating cardiovascular function in patients with severe congestive heart failure and their relation to mortality. CONSENSUS Trial Study Group. Circulation 1990;82:1730-6.
13. Yan AT, Yan RT, Liu PP. Narrative review: pharmacotherapy for chronic heart failure: evidence from recent clinical trials. Ann Intern Med 2005;142:132-45.
14. Borghi C, Boschi S, Ambrosioni E, et al. Evidence of a partial escape of renin-angiotensin-aldosterone blockade in patients with acute myocardial infarction treated with ACE inhibitors. J Clin Pharmacol 1993; 33:40-5.
15. Staessen J, Lijnen P, Fagard R, et al. Rise in plasma concentration of aldosterone during long-term angiotensin II suppression. J Endocrinol 1981;91:457-65.
16. Brown NJ. Aldosterone and vascular inflammation. Hypertension 2008;51:161-7.
17. Struthers AD. Aldosterone escape during angiotensin-converting enzyme inhibitor therapy in chronic heart failure. J Card Fail 1996;2:47-54.
18. Lakkis J, Lu WX, Weir MR. RAAS escape: a real clinical entity that may be important in the progression of cardiovascular and renal disease. Curr Hypertens Rep 2003;5:408-17.
19. Hollenberg NK. Aldosterone in the development and progression of renal injury. Kidney Int 2004;66:1-9.
20. Delcayre C, Silvestre JS, Garnier A, et al. Cardiac aldosterone production and ventricular remodeling. Kidney Int 2000;57:1346-51.
21. Bomback AS, Toto R. Dual blockade of the renin-angiotensinaldosterone system: beyond the ACE inhibitor and angiotensin-II receptor blocker combination. Am J Hypertens 2009;22:1032-40.
22. Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med 1999; 341(10):709-17.
23. Rossignol P, Cleland JG, Bhandari S, et al. Determinants and consequences of renal function variations with aldosterone blocker therapy in heart failure patients after myocardial infarction: insights from the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study. Circulation 2012;125:271-9.
24. Zannad F, McMurray JJ, Krum H, et al. Eplerenone in patients with systolic heart failure and mild symptoms. N Engl J Med 2011;364:11-21.
25. Coca SG, Krumholz HM, Garg AX, et al. Underrepresentation of renal disease in randomized controlled trials of cardiovascular disease. JAMA 2006;296:1377-84.
26. Chertow GM, Normand SL, McNeil BJ. "Renalism": inappropriately low rates of coronary angiography in elderly individuals with renal insufficiency. J Am Soc Nephrol 2004;15:2462-8.
27. Hunt SA, Abraham WT, Chin MH, et al. 2009 focused update incorporated into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2009;119:e391-479.
28. Gross E, Rothstein M, Dombek S, et al. Effect of spironolactone on blood pressure and the renin-angiotensin-aldosterone system in oligoanuric hemodialysis patients. Am J Kidney Dis 2005;46:94-101.
29. Edwards NC, Ferro CJ, Kirkwood H, et al. Effect of spironolactone on left ventricular systolic and diastolic function in patients with early stage chronic kidney disease. Am J Cardiol 2010;106:1505-11.
30. London GM, Pannier B, Guerin AP, et al. Alterations of left ventricular hypertrophy in and survival of patients receiving hemodialysis: follow-up of an interventional study. J Am Soc Nephrol 2001;12: 2759-67.
31. Edwards NC, Steeds RP, Stewart PM, et al. Effect of spironolactone on left ventricular mass and aortic stiffness in early-stage chronic kidney disease: a randomized controlled trial. J Am Coll Cardiol 2009;54:505-12.
32. Asselbergs FW, Diercks GF, Hillege HL, et al. Effects of fosinopril and pravastatin on cardiovascular events in subjects with microalbuminuria. Prevention of Renal and Vascular Endstage Disease Intervention Trial (PREVEND IT) Investigators. Circulation 2004;110:2809-16.
33. de Zeeuw D, Remuzzi G, Parving HH, et al. Albuminuria, a therapeutic target for cardiovascular protection in type 2 diabetic patients with nephropathy. Circulation 2004;110:921-7.
34. Bomback AS, Kshirsagar AV, Amamoo MA, et al. Change in proteinuria after adding aldosterone blockers to ACE inhibitors or angiotensin receptor blockers in CKD: a systematic review. Am J Kidney Dis 2008;51:199-211.
35. Macdonald JE, Kennedy N, Struthers AD. Effects of spironolactone on endothelial function, vascular angiotensin converting enzyme activity, and other prognostic markers in patients with mild heart failure already taking optimal treatment. Heart 2004;90:765-70.
36. Vukusich A, Kunstmann S, Varela C, et al. A randomized, double blind, placebo-controlled trial of spironolactone on carotid-intima media thickness in non diabetic hemodialysis patients. Clin J Am Soc Nephrol 2010;5:1380-7.
37. Lorenz MW, Markus HS, Bots ML, et al. Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation 2007;115:459-67.
38. Vardeny O, Wu DH, Desai A, et al. Influence of baseline and worsening renal function on efficacy of spironolactone in patients with severe heart failure: insights from RALES (Randomized Aldactone Evaluation Study). J Am Coll Cardiol 2012;60:2082-9.
39. Matsumoto Y, Mori Y, Kageyama S, et al. Spironolactone reduces cardiovascular and cerebrovascular morbidity and mortality in hemodialysis patients. J Am Coll Cardiol 2014;63:528-36.
40. Putcha N, Allon M. Management of hyperkalemia in dialysis patients. Semin Dial 2007;20:431-9.
41. Goll RD, Mookerjee BK. Correlation of biochemical parameters in serum and saliva in chronic azotemic patients and patients on chronic hemodialysis. J Dial 1978;2:399-44.
42. Wilson DR, Ing TS, Metcalfe-Gibson A, et al. The chemical composition of faeces in uraemia, as revealed by in-vivo faecal dialysis. Clin Sci 1968;35:197-209.
43. Hayes CP Jr, McLeod ME, Robinson RR. An extrarenal mechanism for the maintenance of potassium balance in severe chronic renal failure. Trans Assoc Am Phys 1967;80:207-16.
44. Bastl C, Hayslett JP, Binder HJ. Increased large intestinal secretion of potassium in renal insufficiency. Kidney Int 1977;12:9-16.
45. Ahmed J, Weisberg LS. Hyperkalemia in dialysis patients. Semin Dial 2001;14:348-56.
46. Kaisar MO, Wiggins KJ, Sturtevant JM, et al. A randomized controlled trial of fludrocortisone for the treatment of hyperkalemia in hemodialysis patients. Am J Kidney Dis 2006;47:809-14.
47. Furuya R, Kumagai H, Sakao T, et al. Potassium-lowering effect of mineralocorticoid therapy in patients undergoing hemodialysis. Nephron 2002;92:76-581.
48. Sugarman A, Brown RS. The role of aldosterone in potassium tolerance: studies in anephric humans. Kidney Int 1988;34:397-403.
49. Vlassopoulos D, Sonikian M, Dardioti V, et al. Insulin and mineralocorticoids influence on extrarenal potassium metabolism in chronic hemodialysis patients. Ren Fail 2001;23:833-42.
50. Nicolis GL, Kahn T, Sanchez A, et al. Glucose induced hyperkalemia in diabetic subjects. Arch Intern Med 1981;141:49-53.
51. Juurlink DN, Mamdani MM, Lee DS, et al. Rates of hyperkalemia after publication of the Randomized Aldactone Evaluation Study. N Engl J Med 2004;351:543-51.
52. Wei L, Struthers AD, Fahey T, et al. Spironolactone use and renal toxicity: population based longitudinal analysis. BMJ 2010;340:c1768.
53. Michea L, Vukusich A, González M, et al. Effect of spironolactone on K(+) homeostasis and ENaC expression in lymphocytes from chronic hemodialysis patients. Kidney Int 2004;66:1647-53.
54. Saudan P, Mach F, Perneger T, et al. Safety of low-dose spironolactone administration in chronic haemodialysis patients. Nephrol Dial Transplant 2003;18:2359-63.
55. Hussain S, Dreyfus DE, Marcus RJ, et al. Is Spironolactone safe for dialysis patients? Nephrol Dial Transpl 2003;18:2364-8.
56. Taheri S, Mortazavi M, Shahidi S, et al. Spironolactone in chronic hemodialysis patients improves cardiac function. Saudi J Kidney Dis Transpl 2009;20:392-7.
57. Matsumoto Y, Kageyama S, Yakushigawa T, et al. Long-term lowdose spironolactone therapy is safe in oligoanuric hemodialysis patients. Cardiology 2009;114:32-8.
58. Wrenger E, Müller R, Moesenthin M, et al. Interaction of spironolactone with ACE inhibitors or angiotensin receptor blockers: analysis of 44 cases. BMJ 2003;327:147-9.
59. Ramadan FH, Masoodi N, El-Solh AA. Clinical factors associated with hyperkalemia in patients with congestive heart failure. J Clin Pharm Ther 2005;30:233-9.
60. Cruz CS, Cruz AA, Marcílio de Souza CA. Hyperkalaemia in congestive heart failure patients using ACE inhibitors and Spironolactone. Nephrol Dial Transplant 2003;18:1814-9.
61. Edwards NC, Steeds RP, Chue CD, et al. The safety and tolerability of spironolactone in patients with mild to moderate chronic kidney disease. Br J Clin Pharmacol 2012;73:447-54.
62. Blankstein R, Bakris GL. Changes in kidney function following heart failure treatment: focus on renin-angiotensin system blockade. Heart Fail Clin 2008;4:425-38.
63. Jose P, Skali H, Anavekar N, et al. Increase in creatinine and cardiovascular risk in patients with systolic dysfunction after myocardial infarction. J Am Soc Nephrol 2006;17:2886-91.
64. Svensson M, Gustafsson F, Galatius S, et al. Hyperkalaemia and impaired renal function in patients taking spironolactone for congestive heart failure: retrospective study. BMJ 2003;327:1141-2.
65. Flevari P, Kalogeropoulou S, Drakou A, et al. Spironolactone improves endothelial and cardiac autonomic function in non heart failure hemodialysis patients. J Hypertens 2013;31:1239-44.
66. Pitt B. Pharmacotherapy: cardiovascular effects of aldosterone blockade in CKD. Nat Rev Cardiol 2009;6:679-80.
67. Bomback AS, Kshirsagar AV, Klemmer PJ. Renal aspirin: will all patients with chronic kidney disease one day take spironolactone? Nat Clin Pract Nephrol 2009;5:74-5.