Long-term eplerenone administration in children with chronic allograft nephropathy maintained stable eGFR levels compared to control (57.53 vs 44.94 mL/min per 1.73 m2, p=0.001) at 36 months.
RCT (n=26)
Does eplerenone preserve renal function and reduce proteinuria in children with chronic allograft nephropathy?
Long-term eplerenone administration in pediatric renal transplant patients with chronic allograft nephropathy preserved eGFR and reduced proteinuria without causing hyperkalemia.
Absolute Event Rate: 57.53% vs 44.94%
p-value: p=.001
Abstract Background Literature supports the protective role of mineralocorticoid antagonist (MRA) against the renal injury induced by aldosterone in kidney transplant recipients. However, there is limited data available regarding the safety and efficacy of MRAs in pediatric renal transplant patients. Therefore, we aimed to investigate the effect of long‐term eplerenone administration in children with chronic allograft nephropathy (CAN). Methods Twenty‐six renal transplant children with biopsy‐proven CAN, an estimated glomerular filtration rate (eGFR ) > 40 mL/min per 1.73 m 2 and with a significant proteinuria were included. Selected patients were randomly divided into two groups as follows; Group 1 ( n = 10) patients received 25 mg/day eplerenone and Group 2 ( n = 16) patients did not receive eplerenone for 36 months. Patients were examined in the renal transplant outpatient clinic biweekly for the first month and once a month thereafter. The primary outcome of the patients was compared. Results Mean eGFR stayed stable in group 1 patients, but significantly decreased in group 2 at 36 months (57.53 ± 7.53 vs. 44.94 ± 8.04 mL/min per 1.73 m 2 , p = .001). Similarly, spot protein–creatinine ratio was significantly lower in group 1 compared to group 2 patients at 36 months (1.02 ± 7.53 vs. 3.61 ± 0.53, p < .001). Eplerenone associated hyperkalemia was not observed in group 1 patients (4.6 ± 0.2 vs. 4.56 ± 0.3, p = .713). Conclusion The long‐term eplerenone administration blunted the chronic allograft nephropathy by maintaining a stable eGFR levels and decreasing urine protein–creatinine ratio. Eplerenone associated hyperkalemia was not observed in our study.
Baskın et al. (Wed,) conducted a rct in Chronic allograft nephropathy (n=26). Eplerenone vs. No eplerenone was evaluated on eGFR at 36 months (mL/min per 1.73 m2) (p=.001). Long-term eplerenone administration in children with chronic allograft nephropathy maintained stable eGFR levels compared to control (57.53 vs 44.94 mL/min per 1.73 m2, p=0.001) at 36 months.