Spironolactone in Post-Transplant Proteinuria: A Safe Alternative Therapy
M V de Sousa1, J P Guida2, C F do Valle1
1Renal Transplant Unit, Division of Nephrology, Department of Medicine, School of Medical Sciences, University of Campinas, UNICAMP, Campinas-SP, Brazil.
Transplantation Proceedings
|May 2, 2017
Summary
Spironolactone effectively reduces proteinuria in kidney transplant recipients with persistent proteinuria. This aldosterone antagonist is a safe treatment option, maintaining stable kidney function and blood pressure.
Area of Science:
- Nephrology
- Transplantation Immunology
- Pharmacology
Background:
- Aldosterone contributes to renal allograft fibrosis, leading to proteinuria and dysfunction.
- Aldosterone antagonists show promise in managing proteinuria and slowing fibrosis progression.
Purpose of the Study:
- To evaluate the efficacy and safety of spironolactone in kidney transplant recipients with persistent proteinuria.
Main Methods:
- Retrospective cohort study of kidney transplant recipients (1993-2015).
- Inclusion criteria: persistent proteinuria >0.5 g/d for >6 months, on spironolactone therapy.
- Patients categorized into low, intermediate, and nephrotic proteinuria groups.
Main Results:
- 140 patients met criteria; groups were demographically similar.
- Spironolactone significantly reduced proteinuria (≥1 g/d) within 6 months, with sustained effect.
- Stable blood pressure and glomerular filtration rate observed.
- Adverse events did not necessitate therapy withdrawal.
Conclusions:
- Spironolactone is a safe and effective treatment for post-transplant proteinuria.
- Particularly beneficial for patients with mild to moderate allograft dysfunction and proteinuria ≥1 g/day.
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