The long-term antiproteinuric effect of eplerenone, a selective aldosterone blocker, in patients with non-diabetic chronic kidney disease

INTRODUCTION: There is still insufficient data concerning the clinical effects of eplerenone, a selective aldosterone blocker, in patients with non-diabetic chronic kidney disease (CKD). METHODS: This study included non-diabetic CKD patients with urinary protein excretion (UPE) of 1.0 g/gCr or more in spite of long-term treatment with renin-angiotensin system (RAS) inhibitors. The clinical effects of eplerenone (25-50 mg/day) were investigated for 12 months. RESULTS: Eplerenone treatment was associated with a 38% reduction in UPE after 12 months. There was only a slight increase in the serum potassium level. The reduction of proteinuria was observed more prominently in patients with modestly impaired renal function than in those with preserved renal function at baseline. CONCLUSION: The long-term administration of low-dose eplerenone was effective and safe for the treatment of non-diabetic CKD patients who showed persistent proteinuria in spite of therapy with RAS inhibitors.