Spironolactone reduces oxidative stress in living donor kidney transplantation: a randomized controlled trial
Autor: | Jonatan Barrera-Chimal, Lluvia A. Marino, Norma A. Bobadilla, Ramón Espinoza, Hilda Juárez, Luis E. Morales-Buenrostro, Juan Antonio Ortega-Trejo, Yvett González-Bobadilla, Rosalba Pérez-Villalva, Norma González, Flor M. Zamora-Mejía |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male Time Factors Physiology HSP72 Heat-Shock Proteins Pilot Projects Pharmacology Spironolactone medicine.disease_cause Kidney Living donor Antioxidants law.invention chemistry.chemical_compound Young Adult Mineralocorticoid receptor Randomized controlled trial Double-Blind Method Lipocalin-2 law Living Donors Medicine Humans Mexico Kidney transplantation Mineralocorticoid Receptor Antagonists business.industry Acute kidney injury medicine.disease Kidney Transplantation Oxidative Stress Treatment Outcome chemistry 8-Hydroxy-2'-Deoxyguanosine Female business Antagonism Oxidative stress Biomarkers Immunosuppressive Agents |
Zdroj: | American journal of physiology. Renal physiology. 317(3) |
ISSN: | 1522-1466 |
Popis: | Mineralocorticoid receptor antagonism prevents acute kidney injury induced by ischemia-reperfusion in rodent and pig preclinical models. In a pilot study, we showed that spironolactone (25 mg) reduced oxidative stress after 5 days of kidney transplant (KT). In the present study, we investigated the effects of higher doses (50 and 100 mg) of spironolactone on kidney function, tubular injury markers, and oxidative stress in living donor KT recipients. We included KT recipients aged 18 yr or older who received immunosuppression therapy with IL-2 receptor antagonist, mycophenolate mofetil, corticosteroids, and tacrolimus with negative cross-match, and compatible blood group. Patients were randomized to receive placebo ( n = 27), spironolactone (50 mg, n = 25), or spironolactone (100 mg, n = 25). Treatment was given from 3 days before and up to 5 days after KT. Serum creatinine, K+, urine neutrophil gelatinase-associated lipocalin-2, heat shock protein 72, and 8-hydroxy-2-deoxyguanosine levels were assessed. As expected, kidney function was improved after KT. Serum K+ remained in the normal range along the study. There was no significant effect of spironolactone on urinary neutrophil gelatinase-associated lipocalin-2 levels, whereas the increase in urinary heat shock protein 72 levels tended to be less intense in the 100 mg spironolactone-treated group ( P = 0.054). In the placebo-treated group, urinary 8-hydroxylated-guanosine levels increased on days 3 and 5 after transplantation. This effect was prevented in patients that received spironolactone. In conclusion, spironolactone reduces the acute increase in urinary oxidative stress in living donor KT recipients. |
Databáze: | OpenAIRE |
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