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(Hypertension. 2008;52:e132.)
© 2008 American Heart Association, Inc.

Letters to the Editor

Spironolactone Attenuates Oxidative Stress in Patients With Chronic Kidney Disease

Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland

Narcyz Knap

Department of Medical Chemistry, Medical University of Gdansk, Gdansk, Poland

Przemysaw Rutkowski

Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland

Alexander Neuwelt

Blood Brain Barrier and Neuro-Oncology Program, Oregon Health and Science University, Portland, Ore

Wojciech Larczyski

Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland

Micha Woniak

Department of Medical Chemistry, Medical University of Gdansk, Gdansk, Poland

Bolesaw Rutkowski

Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

In one of the latest issues of Hypertension, Michea et al¹ reported that the mineralocorticoid receptor antagonist spironolactone attenuates cardiac hypertrophy and oxidative stress of the heart in uremic rats. The results of our recent clinical study indicate that spironolactone acts to decrease the amount of oxidative stress in patients being treated for chronic kidney disease. In an open, randomized, crossover study, 16 white adult patients (10 men and 6 women; mean age: 41 years) with nondiabetic proteinuric chronic kidney disease were evaluated to test the hypothesis that spironolactone combined with standard nephroprotective therapy may act as a clinically beneficial antioxidant.

All of the study participants, during a preliminary period of 8 weeks, received the angiotensin-converting enzyme inhibitor cilazapril (5 mg), angiotensin II type 1 receptor blocker telmisartan (80 mg), and diuretic hydrochlorothiazide (12.5 mg), reducing the blood pressure to <130/80 mm Hg. The trial treatment was either based solely on the unchanged double blockade of the renin-angiotensin system or combined with 25 mg of spironolactone, thus providing triple renin-angiotensin system blockade during the first 2 months of the study, with the alternative being used for the next 2 months. A commercial ELISA kit (Cayman Chemical Co) was then used to measure the urinary excretion of 15-F_2t-isoprostane, widely accepted as a reliable and sensitive marker of oxidative stress in the human body.²

It was found that spironolactone significantly reduced urinary levels of 15-F_2t-isoprostane relative to the control group (ANOVA P=0.035; posthoc P=0.041), . . . [Full Text of this Article]

This article has been cited by other articles:

				L. Michea and E. T. Marusic Response to Spironolactone Attenuates Oxidative Stress in Patients With Chronic Kidney Disease Hypertension, November 1, 2008; 52(5): e134 - e134. [Full Text] [PDF]