Single-dose i.v. Aldactone for congestive heart failure: a preliminary observation

Aldactone (200 mg potassium canrenoate i.v.) was given in a single dose as the sole drug to 30 patients with congestive heart failure (CHF). Of these patients 21 were unresponsive to routine treatment. Clinical improvement was observed in 18 of 30 patients (60%) within 6 h after Aldactone injection. Good diuretic effect (urine volume over 500 ml/6 h) was achieved in 14 patients, including 7 cases who responded dramatically (diuresis 700-1500 ml in 6 h). Plasma aldosterone concentrations before the injection of Aldactone were variable in individual patients. An analysis of their diuretic response to the Aldactone injection within 6 h showed that responders had significantly higher initial plasma aldosterone level (312 +/- 108 pg/ml) than non-responders (152 +/- 31 pg/ml) (p less than 0.02). The same tendency was observed if good or poor clinical effects were considered. Aldactone caused a slight increase in plasma potassium level (0.20 mEq/1) (p less than 0.025). Aldactone given in a single dose i.v. to patients with CHF is a potent drug and can produce a dramatic response in some individuals who are refractory to routine therapy. The beneficial effects of Aldactone could be seen within the first 6 h especially in patients with secondary aldosteronism.