spironolactone has been researched along with Renal Insufficiency in 26 studies
Spironolactone: A potassium sparing diuretic that acts by antagonism of aldosterone in the distal renal tubules. It is used mainly in the treatment of refractory edema in patients with congestive heart failure, nephrotic syndrome, or hepatic cirrhosis. Its effects on the endocrine system are utilized in the treatments of hirsutism and acne but they can lead to adverse effects. (From Martindale, The Extra Pharmacopoeia, 30th ed, p827)
spironolactone : A steroid lactone that is 17alpha-pregn-4-ene-21,17-carbolactone substituted by an oxo group at position 3 and an alpha-acetylsulfanyl group at position 7.
Renal Insufficiency: Conditions in which the KIDNEYS perform below the normal level in the ability to remove wastes, concentrate URINE, and maintain ELECTROLYTE BALANCE; BLOOD PRESSURE; and CALCIUM metabolism. Renal insufficiency can be classified by the degree of kidney damage (as measured by the level of PROTEINURIA) and reduction in GLOMERULAR FILTRATION RATE.
| Excerpt | Relevance | Reference |
|---|---|---|
| "Acute heart failure (HF) patients with renal insufficiency and risk factors for diuretic resistance may be most likely to derive incremental improvement in congestion with the addition of spironolactone." | 9.30 | Spironolactone in Acute Heart Failure Patients With Renal Dysfunction and Risk Factors for Diuretic Resistance: From the ATHENA-HF Trial. ( Ambrosy, AP; Butler, J; Chakraborty, H; DeVore, AD; Felker, GM; Fudim, M; Giczewska, A; Greene, SJ; Hernandez, AF; Kalogeropoulos, AP; McNulty, SE; Mentz, RJ; Vaduganathan, M, 2019) |
| "A previous randomized controlled trial evaluating the use of spironolactone in heart failure patients reported a low risk of hyperkalemia (2%) and renal insufficiency (0%)." | 7.72 | Spironolactone-induced renal insufficiency and hyperkalemia in patients with heart failure. ( Aaronson, KD; Koelling, TM; Tamirisa, KP, 2004) |
| "Serum potassium concentration should be measured immediately before operation to detect hyperkalemia in heart failure patients treated with spironolactone." | 7.71 | Life-threatening hyperkalemia: a complication of spironolactone for heart failure in a patient with renal insufficiency. ( Carpenter, JP; Cheung, AT; Hu, Y, 2002) |
| "Acute heart failure (HF) patients with renal insufficiency and risk factors for diuretic resistance may be most likely to derive incremental improvement in congestion with the addition of spironolactone." | 5.30 | Spironolactone in Acute Heart Failure Patients With Renal Dysfunction and Risk Factors for Diuretic Resistance: From the ATHENA-HF Trial. ( Ambrosy, AP; Butler, J; Chakraborty, H; DeVore, AD; Felker, GM; Fudim, M; Giczewska, A; Greene, SJ; Hernandez, AF; Kalogeropoulos, AP; McNulty, SE; Mentz, RJ; Vaduganathan, M, 2019) |
| " We tested the tolerance of eplerenone according to its expected adverse events: hyperkalemia, metabolic acidosis, hypotension, acute kidney failure, or any other adverse event." | 5.22 | Safety of Eplerenone for Kidney-Transplant Recipients with Impaired Renal Function and Receiving Cyclosporine A. ( Barbe, C; Bertocchio, JP; Jaisser, F; Lavaud, S; Nazeyrollas, P; Rieu, P; Toupance, O, 2016) |
| " Spironolactone and canrenone have a higher risk of hyperkalemia and renal deterioration." | 5.01 | Comparative efficacy and safety of mineralocorticoid receptor antagonists in heart failure: a network meta-analysis of randomized controlled trials. ( Chen, X; Shen, W; Wu, Q; Wu, T; Xu, G; Xu, X; Yang, P; Zhu, D, 2019) |
| "A previous randomized controlled trial evaluating the use of spironolactone in heart failure patients reported a low risk of hyperkalemia (2%) and renal insufficiency (0%)." | 3.72 | Spironolactone-induced renal insufficiency and hyperkalemia in patients with heart failure. ( Aaronson, KD; Koelling, TM; Tamirisa, KP, 2004) |
| "Serum potassium concentration should be measured immediately before operation to detect hyperkalemia in heart failure patients treated with spironolactone." | 3.71 | Life-threatening hyperkalemia: a complication of spironolactone for heart failure in a patient with renal insufficiency. ( Carpenter, JP; Cheung, AT; Hu, Y, 2002) |
| "Additionally, ischemic heart disease adversely impacts the clinical course of HFrEF patients; however, its role in HFpEF is not fully understood." | 3.01 | Role of Ischemic Heart Disease in Major Adverse Renal and Cardiac Events Among Individuals With Heart Failure With Preserved Ejection Fraction (from the TOPCAT Trial). ( Elsaid, O; McCullough, PA; Rahimi, G; Tecson, KM, 2021) |
| "Liver cirrhosis is associated to circulatory abnormalities leading to hypovolemia and stimulation of the renin-angiotensin-aldosterone system (RAAS)." | 1.91 | Decaying kidney function during cirrhosis correlates with remodeling of distal colon aldosterone target gene expression. ( Alvarez de la Rosa, D; González-Alayón, C; Hernández, G; Hernández-Guerra, M; Porrini, E; Rodríguez-Rodríguez, AE; Serrano-Morillas, N; Vastola-Mascolo, A, 2023) |
| "Spironolactone treatment resulted in decreased blood pressure and rise in serum potassium levels." | 1.46 | Apparent mineralocorticoid excess and the long term treatment of genetic hypertension. ( Khattab, A; New, MI; Razzaghy-Azar, M; Yau, M, 2017) |
| " We describe how the TOPCAT DSMB detected, investigated, and adjudicated an unexpectedly large renal adverse event signal midway through the trial, and offer general guidelines for dealing with similar unanticipated occurrences in future trials." | 1.46 | Data and Safety Monitoring Board evaluation and management of a renal adverse event signal in TOPCAT. ( Assmann, SF; Boineau, R; Bristow, MR; Gersh, BJ; Grady, C; Greenberg, BH; Linas, S; McKinlay, SM; Rice, MM; Sharma, K; Singh, S, 2017) |
| "Spironolactone has been noted to attenuate cardiac fibrosis." | 1.35 | Spironolactone attenuates experimental uremic cardiomyopathy by antagonizing marinobufagenin. ( Bagrov, AY; Cooper, CJ; El-Okdi, N; Elkareh, J; Fedorova, OV; Gohara, S; Gupta, S; Haller, S; Malhotra, D; Periyasamy, SM; Shapiro, JI; Shidyak, A; Taleb, M; Tian, J; Xie, Z, 2009) |
| Timeframe | Studies, this research(%) | All Research% |
|---|---|---|
| pre-1990 | 0 (0.00) | 18.7374 |
| 1990's | 2 (7.69) | 18.2507 |
| 2000's | 10 (38.46) | 29.6817 |
| 2010's | 12 (46.15) | 24.3611 |
| 2020's | 2 (7.69) | 2.80 |
| Authors | Studies |
|---|---|
| Serrano-Morillas, N | 1 |
| González-Alayón, C | 1 |
| Vastola-Mascolo, A | 1 |
| Rodríguez-Rodríguez, AE | 1 |
| Hernández, G | 1 |
| Porrini, E | 1 |
| Hernández-Guerra, M | 1 |
| Alvarez de la Rosa, D | 1 |
| Rahimi, G | 1 |
| Tecson, KM | 1 |
| Elsaid, O | 1 |
| McCullough, PA | 1 |
| Villafuerte Ledesma, HM | 1 |
| Peña Porta, JM | 1 |
| Iñigo Gil, P | 1 |
| Martin Azara, P | 1 |
| Ruiz Lalglesia, JE | 1 |
| Tomás LaTorre, A | 1 |
| Martínez Burillo, A | 1 |
| Vernet Perna, P | 1 |
| Álvarez Lipe, R | 1 |
| Yang, P | 1 |
| Shen, W | 1 |
| Chen, X | 1 |
| Zhu, D | 1 |
| Xu, X | 1 |
| Wu, T | 1 |
| Xu, G | 1 |
| Wu, Q | 1 |
| Greene, SJ | 1 |
| Felker, GM | 1 |
| Giczewska, A | 1 |
| Kalogeropoulos, AP | 1 |
| Ambrosy, AP | 1 |
| Chakraborty, H | 1 |
| DeVore, AD | 1 |
| Fudim, M | 1 |
| McNulty, SE | 1 |
| Mentz, RJ | 1 |
| Vaduganathan, M | 1 |
| Hernandez, AF | 1 |
| Butler, J | 1 |
| Ferreira, JP | 1 |
| Santos, M | 1 |
| Almeida, S | 1 |
| Marques, I | 1 |
| Bettencourt, P | 1 |
| Carvalho, H | 1 |
| Takahashi, F | 1 |
| Goto, M | 1 |
| Wada, Y | 1 |
| Hasebe, N | 1 |
| Razzaghy-Azar, M | 1 |
| Yau, M | 1 |
| Khattab, A | 1 |
| New, MI | 1 |
| Bertocchio, JP | 1 |
| Barbe, C | 1 |
| Lavaud, S | 1 |
| Toupance, O | 1 |
| Nazeyrollas, P | 1 |
| Jaisser, F | 1 |
| Rieu, P | 1 |
| Bristow, MR | 1 |
| Sharma, K | 1 |
| Assmann, SF | 1 |
| Linas, S | 1 |
| Gersh, BJ | 1 |
| Grady, C | 1 |
| Rice, MM | 1 |
| Singh, S | 1 |
| Boineau, R | 1 |
| McKinlay, SM | 1 |
| Greenberg, BH | 1 |
| Ueno, H | 1 |
| Yoshimura, M | 1 |
| Nakayama, M | 1 |
| Yamamuro, M | 1 |
| Nishijima, T | 1 |
| Kusuhara, K | 1 |
| Nagayoshi, Y | 1 |
| Kojima, S | 1 |
| Kaikita, K | 1 |
| Sumida, H | 1 |
| Sugiyama, S | 1 |
| Ogawa, H | 1 |
| Tian, J | 1 |
| Shidyak, A | 1 |
| Periyasamy, SM | 1 |
| Haller, S | 1 |
| Taleb, M | 1 |
| El-Okdi, N | 1 |
| Elkareh, J | 1 |
| Gupta, S | 1 |
| Gohara, S | 1 |
| Fedorova, OV | 1 |
| Cooper, CJ | 1 |
| Xie, Z | 1 |
| Malhotra, D | 1 |
| Bagrov, AY | 1 |
| Shapiro, JI | 1 |
| Waldum, B | 1 |
| Westheim, AS | 1 |
| Sandvik, L | 1 |
| Flønaes, B | 1 |
| Grundtvig, M | 1 |
| Gullestad, L | 1 |
| Hole, T | 1 |
| Os, I | 1 |
| Kawarazaki, H | 1 |
| Ando, K | 1 |
| Nagae, A | 1 |
| Fujita, M | 1 |
| Matsui, H | 1 |
| Fujita, T | 1 |
| Wesson, DE | 1 |
| Simoni, J | 1 |
| Epstein, M | 2 |
| Tamirisa, KP | 1 |
| Aaronson, KD | 1 |
| Koelling, TM | 1 |
| Dinsdale, C | 1 |
| Wani, M | 1 |
| Steward, J | 1 |
| O'Mahony, MS | 1 |
| Isabel, J | 1 |
| Champion, JC | 1 |
| Nishiyama, A | 1 |
| Kusaka, T | 1 |
| Kitajima, H | 1 |
| Gledhill, RF | 1 |
| Dutka, M | 1 |
| Dzielski, T | 1 |
| Wojciechowska, J | 1 |
| Heller, L | 1 |
| Trybus, M | 1 |
| Mayan, H | 1 |
| Kantor, R | 1 |
| Farfel, Z | 1 |
| Fleming, T | 1 |
| Borer, J | 1 |
| Lipicky, R | 1 |
| Armstrong, PW | 1 |
| Hu, Y | 1 |
| Carpenter, JP | 1 |
| Cheung, AT | 1 |
| Trial | Phase | Enrollment | Study Type | Start Date | Status | ||
|---|---|---|---|---|---|---|---|
| Aldosterone Targeted Neurohormonal Combined With Natriuresis Therapy - HF (ATHENA-HF)[NCT02235077] | Phase 2 | 360 participants (Actual) | Interventional | 2014-12-30 | Completed | ||
| Study of the Safety of Eplerenone in Cyclosporine A-treated Transplant Recipients[NCT01834768] | Phase 2 | 31 participants (Anticipated) | Interventional | 2013-02-28 | Recruiting | ||
| [information is prepared from clinicaltrials.gov, extracted Sep-2024] | |||||||
Baseline body weight assessment will be completed, and changes in weight documented daily through 96 hours or earlier discharge (NCT02235077)
Timeframe: Randomization through 96 hours or earlier discharge
| Intervention | pounds (Mean) |
|---|---|
| Spironolactone | -8.1 |
| Placebo | -7.5 |
Clinical congestion score will be assessed at randomization, 96 hours, and at discharge. Scale consisted of sum of six signs and symptoms of congestion, each scored 0-3. Zero indicates no sign/symptom and 3 indicates worst case of sign/symptom. Score range 0-18 with 18 being worst score. (NCT02235077)
Timeframe: Randomization through 96 hours
| Intervention | units on a scale (Mean) |
|---|---|
| Spironolactone | -5.59 |
| Placebo | -5.82 |
Dyspnea visual analog scale change from randomization to 96 hours. Scale range 0-100 with 100 being the best possible score. (NCT02235077)
Timeframe: Randomization to 96 hours
| Intervention | units on a scale (Mean) |
|---|---|
| Spironolactone | 17.2 |
| Placebo | 17.9 |
The Core Laboratory at Vermont will determine NT-proBNP levels for calculation of the endpoint from samples obtained at randomization and 96 hours respectively. NT-proBNP was converted to log scale. (NCT02235077)
Timeframe: Randomization to 96 hours
| Intervention | log pg/ml (Mean) |
|---|---|
| Spironolactone | -0.58 |
| Placebo | -0.61 |
Renal function via serum creatinine, will be assessed at randomization and daily through 96 hours (NCT02235077)
Timeframe: Randomization through 96 hours
| Intervention | mg/dl (Mean) |
|---|---|
| Spironolactone | 0.15 |
| Placebo | 0.16 |
Change in serum potassium levels at 96 hours as compared to baseline. (NCT02235077)
Timeframe: Baseline, 96 hours
| Intervention | mEq/L (Mean) |
|---|---|
| Spironolactone | 0.31 |
| Placebo | 0.15 |
Fluid intake and urine output will be assessed daily while in hospital through 96 hours. Net fluid output (output minus input) through 96 hours is reported. (NCT02235077)
Timeframe: Randomization through 96 hours
| Intervention | ml (Mean) |
|---|---|
| Spironolactone | 5824 |
| Placebo | 5507 |
Medications will be reviewed to assess loop diuretic dose requirements through Day 30 following randomization (NCT02235077)
Timeframe: Randomization through Day 30
| Intervention | mg (Mean) |
|---|---|
| Spironolactone | 19.66 |
| Placebo | 30.70 |
All participants will be contacted by telephone at 60 days, +/- 3 days post randomization to assess vital status (death). (NCT02235077)
Timeframe: 60 days post randomization
| Intervention | Participants (Count of Participants) |
|---|---|
| Spironolactone | 8 |
| Placebo | 10 |
Outpatient worsening heart failure symptoms will be assessed from discharge through Day 30 (NCT02235077)
Timeframe: Hospital discharge through Day 30
| Intervention | Participants (Count of Participants) |
|---|---|
| Spironolactone | 19 |
| Placebo | 17 |
4 reviews available for spironolactone and Renal Insufficiency
| Article | Year |
|---|---|
Comparative efficacy and safety of mineralocorticoid receptor antagonists in heart failure: a network meta-analysis of randomized controlled trials.
Topics: Eplerenone; Heart Failure; Hospitalization; Humans; Hyperkalemia; Mineralocorticoid Receptor Antagon | 2019 |
Aldosterone receptor blockade and the role of eplerenone: evolving perspectives.
Topics: Aldosterone; Cardiovascular Diseases; Controlled Clinical Trials as Topic; Dose-Response Relationshi | 2003 |
Aldosterone blockade: an emerging strategy for abrogating progressive renal disease.
Topics: Aldosterone; Algorithms; Disease Progression; Disease Susceptibility; Drug Labeling; Eplerenone; Fib | 2006 |
[Role of aldosterone in oxidative stress and renal injury].
Topics: Aldosterone; Animals; Cardiovascular Diseases; Eplerenone; Humans; Mineralocorticoid Receptor Antago | 2007 |
5 trials available for spironolactone and Renal Insufficiency
| Article | Year |
|---|---|
Role of Ischemic Heart Disease in Major Adverse Renal and Cardiac Events Among Individuals With Heart Failure With Preserved Ejection Fraction (from the TOPCAT Trial).
Topics: Aged; Cardiovascular Diseases; Case-Control Studies; Creatinine; Diabetes Mellitus; Disease Progress | 2021 |
Spironolactone in Acute Heart Failure Patients With Renal Dysfunction and Risk Factors for Diuretic Resistance: From the ATHENA-HF Trial.
Topics: Creatinine; Dose-Response Relationship, Drug; Drug Resistance; Follow-Up Studies; Glomerular Filtrat | 2019 |
Mineralocorticoid receptor antagonism in acutely decompensated chronic heart failure.
Topics: Acute Disease; Aged; Aged, 80 and over; Chronic Disease; Disease Progression; Diuretics; Edema; Fema | 2014 |
Safety of Eplerenone for Kidney-Transplant Recipients with Impaired Renal Function and Receiving Cyclosporine A.
Topics: Adult; Aged; Cyclosporine; Drug Therapy, Combination; Eplerenone; Female; Humans; Immunosuppressive | 2016 |
Renal function in outpatients with chronic heart failure.
Topics: Aged; Analysis of Variance; Antihypertensive Agents; Confidence Intervals; Female; Glomerular Filtra | 2010 |
17 other studies available for spironolactone and Renal Insufficiency
| Article | Year |
|---|---|
Decaying kidney function during cirrhosis correlates with remodeling of distal colon aldosterone target gene expression.
Topics: Aldosterone; Animals; Colon; Epithelial Sodium Channels; Gene Expression; Hypovolemia; Kidney; Liver | 2023 |
Severe renal failure and thrombotic microangiopathy induced by malignant hypertension successfully treated with spironolactone.
Topics: Adult; Humans; Hypertension, Malignant; Male; Remission Induction; Renal Insufficiency; Severity of | 2018 |
Successful Treatment with an Antihypertensive Drug Regimen Including Eplerenone in a Patient with Malignant Phase Hypertension with Renal Failure.
Topics: Adrenergic beta-Antagonists; Adult; Antihypertensive Agents; Benzimidazoles; Biphenyl Compounds; Cal | 2015 |
Apparent mineralocorticoid excess and the long term treatment of genetic hypertension.
Topics: 11-beta-Hydroxysteroid Dehydrogenases; Adolescent; Adult; Blood Pressure; Child; Child, Preschool; D | 2017 |
Data and Safety Monitoring Board evaluation and management of a renal adverse event signal in TOPCAT.
Topics: Clinical Trials as Topic; Clinical Trials Data Monitoring Committees; Heart Failure; Humans; Hyperka | 2017 |
Clinical factors affecting serum potassium concentration in cardio-renal decompensation syndrome.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Angiotensin II Type 1 Receptor Blockers; Angiotensin-Con | 2010 |
Spironolactone attenuates experimental uremic cardiomyopathy by antagonizing marinobufagenin.
Topics: Animals; Bufanolides; Canrenone; Cardiomyopathies; Cardiotonic Agents; Cells, Cultured; Disease Mode | 2009 |
Mineralocorticoid receptor activation contributes to salt-induced hypertension and renal injury in prepubertal Dahl salt-sensitive rats.
Topics: 8-Hydroxy-2'-Deoxyguanosine; Animals; Antihypertensive Agents; Antioxidants; Blood Pressure; Cyclic | 2010 |
Acid retention during kidney failure induces endothelin and aldosterone production which lead to progressive GFR decline, a situation ameliorated by alkali diet.
Topics: Acid-Base Equilibrium; Acidosis; Administration, Oral; Aldosterone; Animals; Bicarbonates; Calcium G | 2010 |
Spironolactone-induced renal insufficiency and hyperkalemia in patients with heart failure.
Topics: Adrenergic beta-Antagonists; Age Factors; Aged; Algorithms; Body Weight; Case-Control Studies; Creat | 2004 |
Tolerability of spironolactone as adjunctive treatment for heart failure in patients over 75 years of age.
Topics: Age Factors; Aged; Aged, 80 and over; Angiotensin-Converting Enzyme Inhibitors; Diuretics; Female; H | 2005 |
Junctional escape rhythm secondary to acute hyperkalemic renal failure in the setting of concurrent beta-blocker therapy.
Topics: Adrenergic beta-Antagonists; Aged; Angiotensin-Converting Enzyme Inhibitors; Bradycardia; Diuretics; | 2006 |
Secondary hyperkalaemic paralysis.
Topics: Humans; Hyperkalemia; Mineralocorticoid Receptor Antagonists; Paralysis; Renal Insufficiency; Spiron | 1998 |
[Drug-related hyperkalemia resulted from spironolactone and angiotensin converting enzyme inhibitors therapy].
Topics: Aged; Angiotensin-Converting Enzyme Inhibitors; Diuretics; Humans; Hyperkalemia; Male; Renal Insuffi | 1999 |
Trans-tubular potassium gradient in patients with drug-induced hyperkalemia.
Topics: Aged; Aged, 80 and over; Aldosterone; Angiotensin-Converting Enzyme Inhibitors; Captopril; Creatinin | 2001 |
Report from the 94th Cardiovascular and Renal Drugs Advisory Committee Meeting, October 11, 2001.
Topics: Adrenergic beta-Antagonists; Advisory Committees; Age Factors; Angiotensin Receptor Antagonists; Ang | 2001 |
Life-threatening hyperkalemia: a complication of spironolactone for heart failure in a patient with renal insufficiency.
Topics: Aged; Aortic Aneurysm, Abdominal; Blood Gas Analysis; Heart Failure; Humans; Hyperkalemia; Intraoper | 2002 |