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Eplerenone hemodialysis

Kevin Quach, Lyubov Lvtvyn, Colin Baigent, Joe Bueti, Amit X Garg, Carmel Hawley, Richard Haynes, Braden Manns, Vlado Perkovic, Christian G Rabbat, Ron Wald, Michael Walsh
BACKGROUND: Patients who require dialysis are at high risk for cardiovascular mortality, which may be improved by mineralocorticoid receptor antagonists (MRAs). STUDY DESIGN: Systematic review and meta-analysis of randomized controlled trials. SETTING & POPULATION: Adults undergoing long-term hemodialysis or peritoneal dialysis with or without heart failure. SELECTION CRITERIA FOR STUDIES: Randomized controlled trials evaluating an MRA in dialysis and reported at least one outcome of interest...
October 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Michael Walsh, Braden Manns, Amit X Garg, Joe Bueti, Christian Rabbat, Andrew Smyth, Jessica Tyrwhitt, Jackie Bosch, Peggy Gao, P J Devereaux, Ron Wald
BACKGROUND AND OBJECTIVES: Mineralocorticoid receptor antagonism reduces morbidity and mortality in patients with heart failure, but the safety of these drugs in patients receiving dialysis is unclear. This study evaluated whether hyperkalemia and/or hypotension limited the use of eplerenone, a selective mineralocorticoid receptor antagonist, in hemodialysis patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a randomized controlled trial of prevalent patients receiving hemodialysis at five Canadian centers...
September 4, 2015: Clinical Journal of the American Society of Nephrology: CJASN
Maja Martinuč Bergoč, Jelka Lindič, Damjan Kovač, Dušan Ferluga, Jernej Pajek
Hantaviruses can be associated with severe form of hemorrhagic fever with renal syndrome although there are only a few cases reporting chronic kidney disease after hantavirus infection. We report a severe nonresolving chronic renal failure after protracted Dobrava hantavirus infection successfully treated with corticosteroids. Ten days after working in a basement a 33-year-old man fell seriously ill, with high fever, chills, diffuse myalgia, headache and abdominal pain. After hospital admission a diagnosis of hemorrhagic fever with renal syndrome caused by Dobrava hantavirus was made...
August 2013: Therapeutic Apheresis and Dialysis
William L Baker, William B White
OBJECTIVE: To evaluate the literature supporting the safe use of mineralocorticoid antagonists (MRAs) in patients with end-stage renal disease who are receiving hemodialysis. DATA SOURCES: A review of the literature was performed using MEDLINE (1950 through week 2 of February 2012) using the key words and MeSH terms mineralocorticoid antagonists, aldosterone antagonists, spironolactone, or eplerenone combined with dialysis, renal disease, or kidney disease. STUDY SELECTION AND DATA EXTRACTION: Studies eligible for inclusion evaluated the impact of MRAs on serum potassium levels in patients with end-stage renal disease receiving hemodialysis...
June 2012: Annals of Pharmacotherapy
L Shavit, D Neykin, M Lifschitz, I Slotki
INTRODUCTION AND AIMS: Recent studies have suggested that aldosterone has many effects in addition to its ability to cause the kidney to retain sodium. To test the hypothesis that aldosterone can cause hypertension in a manner that does not involve renal sodium retention, we administered eplerenone, a specific aldosterone antagonist, to oligo-anuric chronic hemodialysis patients who had HTN. METHODS: 220 chronic hemodialysis patients underwent initial screening...
November 2011: Clinical Nephrology
Doson Chua, Anita Lo, Chris Lo
BACKGROUND: Spironolactone is used in the treatment of cardiovascular disease, but is contraindicated in renal dysfunction due to the risk of hyperkalemia. It is not known if patients with end-stage renal disease (ESRD) on hemodialysis are at the same risk for hyperkalemia. The objective of this study was to systematically review the evidence evaluating the incidence of hyperkalemia with spironolactone use in ESRD patients on hemodialysis. HYPOTHESIS: Spironolactone use in ESRD patients on hemodialysis may not lead to greater incidence of hyperkalemia...
October 2010: Clinical Cardiology
William R Ravis, Susan Reid, Domenic A Sica, Dwain S Tolbert
The influence of renal impairment on the pharmacokinetics of eplerenone following single and multiple dosing was evaluated. Subjects (n = 64) were stratified based on creatinine clearance values as follows: renal impairment (mild, moderate, severe), hemodialysis, and normal matches. Subjects received a single dose of eplerenone 100 mg on day 1 and then received 100 mg once daily on days 3 to 8. There were no statistically significant differences between any of the renal impairment groups and their matched-normal groups for area under the curve (AUC), C(max), or CL/F or CL/F/WT following either single or multiple dosing (P > or = ...
July 2005: Journal of Clinical Pharmacology
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