TUESDAY, July 28 (HealthDay News) -- In patients with early-stage chronic kidney disease and good blood pressure control, the addition of spironolactone to treatment with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers can improve markers of cardiovascular disease, according to a study in the August 4 issue of the Journal of the American College of Cardiology.
After a run-in phase with the aldosterone antagonist spironolactone, Nicola C. Edwards and colleagues from the University of Birmingham in the United Kingdom randomly assigned 112 patients with stage 2 and 3 chronic kidney disease and well-controlled blood pressure to continue spironolactone or receive a placebo. All patients continued to receive established treatment with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers.
After 40 weeks of treatment, the researchers found that the spironolactone group had significant improvements in left ventricular mass, pulse wave velocity, augmentation index, and aortic distensibility compared with placebo.
"In patients with early-stage chronic kidney disease, the use of spironolactone resulted in improvements in important prognostic markers of cardiovascular disease; most of these effects were statistically independent of the change in blood pressure," Edwards and colleagues conclude.
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