Open AccessEffects of Spironolactone on Dialysis Patients With Refractory Hypertension: A Randomized Controlled Study
Author(s) -
Ni Xiaoying,
Zhang Jisheng,
Zhang Ping,
Wu Fuquan,
Xia Min,
Ying Guanghui,
Chen Jianghua
Publication year - 2014
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12374
Subject(s) - spironolactone , medicine , ambulatory blood pressure , refractory (planetary science) , ambulatory , blood pressure , placebo , randomized controlled trial , morning , dialysis , urology , aldosterone , physics , alternative medicine , pathology , astrobiology
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.