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Spironolactone in chronic hemodialysis patients improves cardiac function

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Author(s): Taheri Shahram | Mortazavi Mojhgan | Shahidi Shahrzad | Pourmoghadas Ali | Garakyaraghi Mohammad | Seirafian Shiva | Eshaghian Afrooz | Ghassami Maryam

Journal: Saudi Journal of Kidney Diseases and Transplantation
ISSN 1319-2442

Volume: 20;
Issue: 3;
Start page: 392;
Date: 2009;
Original page

Keywords: Ejection fraction (EF) | Hemodialysis | Heart failure | Left ventricle (LV) mass | Spironolactone

ABSTRACT
We performed this study to assess whether low dose spironolactone could be admi-nistered in hemodialysis (HD) patients with moderate to severe heart failure to improve cardio-vascular function and reduce hospitalization without inducing hyperkalemia. We enrolled 16 chro-nic HD patients with moderate to severe heart failure and left ventricle ejection fraction :5 45%. In a double blinded randomized placebo controlled study, one group of 8 patients received 25 mg of spi-ronolactone after each dialysis session within six months, and the rest received a placebo. Echo-cardiography was performed on all the patients to assess ejection fraction and left ventricular mass during 12 hours after completion of hemodialysis at the beginning and the end of study. Serum potassium was measured predialysis every 4 weeks. The mean ejection fraction increased signi-ficantly more in spironolactone group during the study period than in the placebo group (6.2 ± 1.64 vs. 0.83 ± 4.9, P= 0.046). The mean left ventricular mass decreased in the spironolactone group, but increased significantly in the placebo group during the period (-8.4 ± 4.72 vs. 3 ± 7.97. 95%, P= 0.021). The incidence of hyperkalemia was not significantly increased in the study or controlled groups. In conclusion, we found in this study that administration of spironolactone in chronic HD patients with moderate to severe heart failure substantially improved their cardiac function and decreases left ventricular mass without development of significant hyperkalemia.
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