Key result
Spironolactone 25 mg/day added to standard therapy significantly increased serum potassium (p<0.05) without significantly altering serum sodium, creatinine, or blood urea at 3 months.
Why the study?
The study was conducted to evaluate the effect of a single daily 25 mg dose of spironolactone on serum electrolytes and kidney function tests in patients with severe chronic left-sided heart failure.
Does spironolactone 25 mg/day affect serum electrolytes and renal function in patients with severe chronic left sided heart failure?
RCT (n=60)
Does spironolactone 25 mg/day affect serum electrolytes and renal function in patients with severe chronic left sided heart failure?
Low-dose spironolactone (25 mg/day) in severe heart failure significantly increases serum potassium without adversely affecting renal function, highlighting the need for routine monitoring.
Answers are grounded in this paper and cite their sources.
Requires close monitoring of electrolytes and renal function with low-dose spironolactone in severe HF; leaves open safety signals for larger trials.
The aim: To evaluate the effect of single daily 25 mg of spironolactone on serum electrolytes and kidney function tests in patients with severe chronic left sided heart failure. Materials and methods: 60 patients with severe chronic left sided heart failure were enrolled in this study and they were divided in to 2 equal groups’ one group with standard therapy of HF and the other with spironolactone in a dose of 25 mg / day, as an additive therapy to the standard one. Serum electrolytes and kidney function tests were assessed at the beginning of the study and after 3 months. Results: A significant increment in serum potassium (p<0.05) was observed in the spironolactone group after 3 months treatment, while no significant reduction in serum sodium (p>0.05) and no significant increase in serum creatinine and blood urea (p>0.05) was noticed in the same group, control group showed no significant changes (p>0.05), in both serum electrolytes (S.K and S.Na) and renal function tests (S.C and B.U). Conclusions: Spironolactone caused a significant elevation of serum potassium level but this elevation is still with the clinically accepted ranges when low dose of spironolactone is used and with intact renal function. Serum creatinine level was not significantly increased with 25 mgl day of spironolactone. We conclude that Renal function tests namely blood urea and serum Creatinine, and serum potassium should be closely monitored in patients on spironolactone therapy especially those patients who use ACEI and ARBs in addition.
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Almedeny et al. (2021) conducted an RCT in severe chronic left sided heart failure (n=60). Spironolactone vs. Standard therapy of HF was evaluated on Serum electrolytes and kidney function tests (p=<0.05). Spironolactone 25 mg/day added to standard therapy significantly increased serum potassium (p<0.05) without significantly altering serum sodium, creatinine, or blood urea at 3 months.
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