Aldosterone antagonist therapy and its relationship with inflammation, fibrosis, thrombosis, mineral-bone disorder and cardiovascular complications in peritoneal dialysis (PD) patients

Autor: Jacek Manitius, Rafał Donderski, Paweł Stróżecki, Anna Stefańska, Magdalena Grajewska, Grażyna Odrowąż-Sypniewska, Beata Sulikowska, Ilona Miśkowiec, Joanna Siódmiak
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Nephrology
Thrombosis markers
Male
Hyperkalemia
medicine.medical_treatment
030232 urology & nephrology
Blood Pressure
030204 cardiovascular system & hematology
Spironolactone
chemistry.chemical_compound
0302 clinical medicine
Mineralocorticoid receptor
Transforming Growth Factor beta
Cardiovascular complications
Aldosterone
Mineralocorticoid Receptor Antagonists
Aged
80 and over
Nephrology – Original Paper
Middle Aged
P-Selectin
Cardiovascular Diseases
Echocardiography
Parathyroid Hormone
Matrix Metalloproteinase 2
Female
medicine.symptom
Adult
medicine.medical_specialty
Urology
Peritoneal dialysis
Pulse Wave Analysis
03 medical and health sciences
Vascular Stiffness
Internal medicine
medicine
Humans
Mineral and bone markers
Renal Insufficiency
Chronic
Aged
Inflammation
Chronic Kidney Disease-Mineral and Bone Disorder
business.industry
Interleukin-6
Thrombosis
medicine.disease
Fibrosis
Endocrinology
Blood pressure
chemistry
Osteopontin
business
Biomarkers
Kidney disease
Zdroj: International Urology and Nephrology
ISSN: 1573-2584
0301-1623
Popis: Background High aldosterone level may contribute to pathogenesis of hypertension, vessels damage and cardiovascular system deterioration in chronic kidney disease patients. Besides its classical action via mineralocorticoid receptor, aldosterone is also involved in cell growth, inflammation, oxidative stress, endothelial dysfunction and exerts fibroproliferative effects. The aim of the study was to assess whether aldosterone antagonist treatment may influence serum level of inflammatory, fibrosis, thrombosis and mineral-bone metabolism markers in peritoneal dialysis (PD) patients and blood pressure, aortic stiffness, echocardiographic indices after 12 months of treatment. Methods Twenty-two patients on PD were assigned to spironolactone treatment in dose of 50 mg daily during 12 months. Fifteen PD patients were assigned to control group. Echocardiographic indices, PVW, SBP, DBP (mean values from ABPM) and biochemical parameters such as: aldosterone, osteopontin, IL-6, selectin-P, TGF-β, PTH, MMP-2 were performed at the beginning and after 12 months in spironolactone and control group. Results There were no statistically significant differences in echocardiographic indices, PWV, BP (ABPM readings) and biochemical markers: MMP-2, serum aldosterone, TGF-β, IL-6, selectin-P, PTH level after 12 months of spironolactone treatment. There was statistically significant rise in osteopontin level after 12 months of spironolactone treatment. Episodes of life-threatening hyperkalemia were not reported. Conclusions Aldosterone antagonists use in PD patients seems to be safe. Longer duration or higher dosage of spironolactone seems to be more effective in improving cardiovascular system status in PD patients. Further studies are required to determine relationship between mineralocorticoid receptor blockade and mineral-bone disturbances in PD patients.
Databáze: OpenAIRE
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