Open AccessComparison of spironolactone and trichlormethiazide as add‐on therapy to renin–angiotensin blockade for reduction of albuminuria in diabetic patients
Author(s) -
Hase Michiyo,
Babazono Tetsuya,
Ujihara Noriko,
Uchigata Yasuko
Publication year - 2013
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.12029
Subject(s) - medicine , albuminuria , spironolactone , urology , endocrinology , diabetes mellitus , blockade , creatinine , kidney disease , pharmacology , aldosterone , receptor
To compare the efficacy of spironolactone and trichlormethiazide, as add‐on therapy to renin–angiotensin system ( RAS ) blockade, for reduction of albuminuria in diabetic patients with chronic kidney disease ( CKD ), we conducted this randomized, open‐labeled, parallel‐group, active‐controlled, per‐protocol‐design study. Type 2 diabetic patients receiving an angiotensin‐converting enzyme inhibitor or angiotensin II receptor blocker, with persistent albuminuria (≥100 mg/g creatinine) were randomly assigned to either spironolactone (25 mg/day) or trichlormethiazide (2 mg/day). The primary outcome was the change in albuminuria at 24 weeks of treatment. In patients who completed 24 weeks of treatment with spironolactone ( n = 18) and trichlormethiazide ( n = 15), albuminuria decreased significantly by −57.6 ± 21.3% ( SD ) ( P < 0.001) and −48.4 ± 27.1% ( P < 0.001), respectively. There was no significant difference in the change in albuminuria between groups ( P = 0.270). This pilot study suggests add‐on therapy with spironolactone or trichlormethiazide to RAS blockade may be comparably beneficial to reducing albuminuria in type 2 diabetic patients. This trial was registered with UMIN ‐ CTR (no. UMIN 8914).