Spironolactone significantly reduced placebo-corrected morning blood pressure by 16.7/7.6 mm Hg and 24-hour ambulatory blood pressure by 10.9/5.8 mm Hg in dialysis patients.
RCT (n=82)
Double-blind
randomized
Does spironolactone reduce blood pressure in dialysis patients with refractory hypertension?
Spironolactone as an add-on therapy significantly reduces ambulatory and morning blood pressure in dialysis patients with refractory hypertension without causing significant hyperkalemia.
Estimación del efecto: Placebo-corrected morning BP reduction of 16.7/7.6 mm Hg; 24-hour ambulatory BP reduction of 10.9/5.8 mm Hg
The purpose of this study was to evaluate the effects of spironolactone on dialysis patients with refractory hypertension and possible adverse effects. This was a 12-week prospective, randomized, double-blind trial of 82 patients randomly assigned to 12-week treatment with 25 mg/d spironolactone or placebo as add-on therapy. Visits were scheduled at the start of treatment and after 12 weeks. Measurements of 24-hour ambulatory blood pressure (BP) monitoring and morning BP were performed. After 12 weeks, spironolactone significantly improved refractory hypertension. Average placebo-corrected morning BP was reduced by 16.7/7.6 mm Hg. Mean 24-hour ambulatory BP was reduced by 10.9/5.8 mm Hg. In contrast, serum aldosterone levels in the spironolactone group slightly increased and serum potassium levels insignificantly increased. This study has demonstrated that spironolactone (50 mg) safely and effectively reduces BP in patients with refractory hypertension undergoing dialysis.
Ni et al. (Tue,) conducted a rct in Refractory hypertension in dialysis patients (n=82). Spironolactone vs. Placebo was evaluated on Morning blood pressure and 24-hour ambulatory blood pressure (Placebo-corrected morning BP reduction of 16.7/7.6 mm Hg; 24-hour ambulatory BP reduction of 10.9/5.8 mm Hg). Spironolactone significantly reduced placebo-corrected morning blood pressure by 16.7/7.6 mm Hg and 24-hour ambulatory blood pressure by 10.9/5.8 mm Hg in dialysis patients.
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