Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Jornal Brasileiro de Nefrologia |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002019000300345 |
Resumo: | ABSTRACT Introduction: There is evidence that aldosterone plays a role in the pathogenesis of vascular calcification. The aim of this study was to evaluate the effect of spironolactone, a mineralocorticoid receptor antagonist, on the progression of coronary calcification (CC) in peritoneal dialysis patients and to identify the factors involved in this progression. Methods: Thirty-three patients with a coronary calcium score (CCS) ≥ 30, detected through multi-detector computed tomography (MDCT) and expressed in Agatston units, were randomly assigned to a group receiving 25mg spironolactone per day for 12 months (spironolactone group) and a control group not receiving this drug. The primary outcome was a percentage change in CCS from baseline to end of the study (relative progression), when a further MDCT was conducted. Patients who had progression of CC were compared with those who did not progress. Results: Sixteen patients, seven in the spironolactone group and nine in the control group, concluded the study. The relative progression of the CCS was similar in both groups, 17.2% and 27.5% in the spironolactone and control groups respectively. Fifty-seven percent of the treated patients and 67% of those in the control group presented progression in the CC scores (p = 0.697). Progressor patients differed from non-progressors because they presented higher levels of calcium and low-density lipoprotein cholesterol and lower levels of albumin. Conclusion: In peritoneal dialysis patients, spironolactone did not attenuate the progression of CC. However, large-scale studies are needed to confirm this observation. Disorders of mineral metabolism and dyslipidemia are involved in the progression of CC. |
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Jornal Brasileiro de Nefrologia |
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Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot studyRenal Insufficiency, ChronicVascular CalcificationPeritoneal DialysisSpironolactoneABSTRACT Introduction: There is evidence that aldosterone plays a role in the pathogenesis of vascular calcification. The aim of this study was to evaluate the effect of spironolactone, a mineralocorticoid receptor antagonist, on the progression of coronary calcification (CC) in peritoneal dialysis patients and to identify the factors involved in this progression. Methods: Thirty-three patients with a coronary calcium score (CCS) ≥ 30, detected through multi-detector computed tomography (MDCT) and expressed in Agatston units, were randomly assigned to a group receiving 25mg spironolactone per day for 12 months (spironolactone group) and a control group not receiving this drug. The primary outcome was a percentage change in CCS from baseline to end of the study (relative progression), when a further MDCT was conducted. Patients who had progression of CC were compared with those who did not progress. Results: Sixteen patients, seven in the spironolactone group and nine in the control group, concluded the study. The relative progression of the CCS was similar in both groups, 17.2% and 27.5% in the spironolactone and control groups respectively. Fifty-seven percent of the treated patients and 67% of those in the control group presented progression in the CC scores (p = 0.697). Progressor patients differed from non-progressors because they presented higher levels of calcium and low-density lipoprotein cholesterol and lower levels of albumin. Conclusion: In peritoneal dialysis patients, spironolactone did not attenuate the progression of CC. However, large-scale studies are needed to confirm this observation. Disorders of mineral metabolism and dyslipidemia are involved in the progression of CC.Sociedade Brasileira de Nefrologia2019-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002019000300345Brazilian Journal of Nephrology v.41 n.3 2019reponame:Jornal Brasileiro de Nefrologiainstname:Sociedade Brasileira de Nefrologia (SBN)instacron:SBN10.1590/2175-8239-jbn-2019-0009info:eu-repo/semantics/openAccessGueiros,Ana Paula SantanaGueiros,José Edevanilson de BarrosNóbrega,Karina TavaresCalado,Eveline BarrosMatta,Marina Cadena daTorres,Leuridan CavalcanteSouza,Alex Sandro RollandCasarini,Dulce ElenaCarvalho,Aluizio Barbosa deeng2019-09-24T00:00:00Zoai:scielo:S0101-28002019000300345Revistahttp://www.bjn.org.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||jbn@sbn.org.br2175-82390101-2800opendoar:2019-09-24T00:00Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN)false |
dc.title.none.fl_str_mv |
Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study |
title |
Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study |
spellingShingle |
Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study Gueiros,Ana Paula Santana Renal Insufficiency, Chronic Vascular Calcification Peritoneal Dialysis Spironolactone |
title_short |
Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study |
title_full |
Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study |
title_fullStr |
Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study |
title_full_unstemmed |
Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study |
title_sort |
Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study |
author |
Gueiros,Ana Paula Santana |
author_facet |
Gueiros,Ana Paula Santana Gueiros,José Edevanilson de Barros Nóbrega,Karina Tavares Calado,Eveline Barros Matta,Marina Cadena da Torres,Leuridan Cavalcante Souza,Alex Sandro Rolland Casarini,Dulce Elena Carvalho,Aluizio Barbosa de |
author_role |
author |
author2 |
Gueiros,José Edevanilson de Barros Nóbrega,Karina Tavares Calado,Eveline Barros Matta,Marina Cadena da Torres,Leuridan Cavalcante Souza,Alex Sandro Rolland Casarini,Dulce Elena Carvalho,Aluizio Barbosa de |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Gueiros,Ana Paula Santana Gueiros,José Edevanilson de Barros Nóbrega,Karina Tavares Calado,Eveline Barros Matta,Marina Cadena da Torres,Leuridan Cavalcante Souza,Alex Sandro Rolland Casarini,Dulce Elena Carvalho,Aluizio Barbosa de |
dc.subject.por.fl_str_mv |
Renal Insufficiency, Chronic Vascular Calcification Peritoneal Dialysis Spironolactone |
topic |
Renal Insufficiency, Chronic Vascular Calcification Peritoneal Dialysis Spironolactone |
description |
ABSTRACT Introduction: There is evidence that aldosterone plays a role in the pathogenesis of vascular calcification. The aim of this study was to evaluate the effect of spironolactone, a mineralocorticoid receptor antagonist, on the progression of coronary calcification (CC) in peritoneal dialysis patients and to identify the factors involved in this progression. Methods: Thirty-three patients with a coronary calcium score (CCS) ≥ 30, detected through multi-detector computed tomography (MDCT) and expressed in Agatston units, were randomly assigned to a group receiving 25mg spironolactone per day for 12 months (spironolactone group) and a control group not receiving this drug. The primary outcome was a percentage change in CCS from baseline to end of the study (relative progression), when a further MDCT was conducted. Patients who had progression of CC were compared with those who did not progress. Results: Sixteen patients, seven in the spironolactone group and nine in the control group, concluded the study. The relative progression of the CCS was similar in both groups, 17.2% and 27.5% in the spironolactone and control groups respectively. Fifty-seven percent of the treated patients and 67% of those in the control group presented progression in the CC scores (p = 0.697). Progressor patients differed from non-progressors because they presented higher levels of calcium and low-density lipoprotein cholesterol and lower levels of albumin. Conclusion: In peritoneal dialysis patients, spironolactone did not attenuate the progression of CC. However, large-scale studies are needed to confirm this observation. Disorders of mineral metabolism and dyslipidemia are involved in the progression of CC. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-09-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002019000300345 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002019000300345 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/2175-8239-jbn-2019-0009 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Nefrologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Nefrologia |
dc.source.none.fl_str_mv |
Brazilian Journal of Nephrology v.41 n.3 2019 reponame:Jornal Brasileiro de Nefrologia instname:Sociedade Brasileira de Nefrologia (SBN) instacron:SBN |
instname_str |
Sociedade Brasileira de Nefrologia (SBN) |
instacron_str |
SBN |
institution |
SBN |
reponame_str |
Jornal Brasileiro de Nefrologia |
collection |
Jornal Brasileiro de Nefrologia |
repository.name.fl_str_mv |
Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN) |
repository.mail.fl_str_mv |
||jbn@sbn.org.br |
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1752122065665654784 |