albumin - publications

Predict more albumin - ligand interactions now!


1. Diabet Med. 2012 Jan 24. doi: 10.1111/j.1464-5491.2012.03585.x. [Epub ahead of
print]

Spironolactone diminishes urinary albumin excretion in patients with type 1
diabetes and microalbuminuria: a randomized placebo-controlled crossover study.

Nielsen SE, Persson F, Frandsen E, Sugaya T, Hess G, Zdunek D, Shjoedt KJ,
Parving HH, Rossing P.

Steno Diabetes Center, Niels Steensens Vej, Gentofte, Denmark.

Aims:  Adding aldosterone receptor blockade to standard renoprotective treatment
may provide additional renoprotection in patients with overt nephropathy. We
expected an impact of spironolactone in early diabetic nephropathy, and for this
hypothesis we studied the effect on markers of glomerular and tubular damage in
patients with Type 1 diabetes and persistent microalbuminuria. Methods:  A
double-blind, randomized, placebo-controlled crossover study in 21 patients with
Type 1 diabetes and microalbuminuria using spironolactone 25 mg or placebo once
daily, for 60 days added to standard antihypertensive treatment. After each
treatment period, the primary end point (urinary albumin excretion/24 h),
secondary endpoint (24-h blood pressure), GFR and markers of tubular damage
(urinary liver-type fatty-acid binding protein, neutrophil gelatinase-associated
lipocalin and kidney injury molecule 1) were evaluated. Results:  All patients
completed the study. During spironolactone treatment, urinary albumin excretion
rate was reduced by 60% (range 21-80%), from 90 mg/24 h to 35 mg/24 h (P = 0.01).
Blood pressure (24 h) did not change during spironolactone treatment (P > 0.2 for
all comparisons). The GFR decreased from 78 (6) mL/min.1.73m(2) to 72 (6)
mL/min.1.73m(2) (P = 0.003). Urinary liver-type fatty-acid binding protein,
neutrophil gelatinase-associated lipocalin and kidney injury molecule 1 did not
change during treatment (P > 0.3 for all comparisons). Treatment was
well-tolerated, but two patients had severe hyperkalaemia (plasma
potassium = 5.7 mmol/l), which was sufficiently treated with diuretics and
dietary intervention. Conclusions:  Spironolactone treatment in addition to
standard renoprotective treatment lowers urinary albumin excretion in
microalbuminuric patients with Type 1 diabetes, and thus may offer additional
renoprotection independent of blood pressure. © 2012 The Authors. Diabetic
Medicine © 2012 Diabetes UK.

© 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

PMID: 22268920 [PubMed - as supplied by publisher]