Effects of Spironolactone on Cardiovascular Complications in Hemodialysis Patients of Taleghani Hospital During the Period of 2016-2017: A Randomized Double-Blind Controlled Clinical Trial

Background: There is recent evidence that aldosterone plays a role in the pathogenesis of cardiovascular diseases in dialysis patients, which leads to the opportunity to block its actions for the benefit of these patients. In non-dialytic chronic kidney diseases, spironolactone was safe and effective in reducing left ventricular hypertrophy. However, its routine use has been precluded in hemodialysis patients due to the risk of hyperkalemia. The aim of the present study was to verify the safety and efficacy of spironolactone in the regression of left ventricular hypertrophy and ejection fraction in hemodialysis patients undergoing pharmacotherapeutic monitoring. Methods: We performed a controlled, randomized, double-blind study evaluating 48 hemodialysis patients divided into 2 groups. The first group received spironolactone at a dose of 25 mg after hemodialysis over a few weeks, and the second group was the control. The patients were followed up for 9 months. Results: Both groups were composed of 24 patients each. The study groups did not differ in their baseline characteristics. The group receiving spironolactone had a significant improvement in the left ventricular mass index and ejection fraction in comparison with the control group (P<0.05). Conclusions: Spironolactone treatment in hemodialysis patients was safe and effective in regressing left ventricular hypertrophy and improving the ejection fraction as major risk factors for cardiovascular events in these patients.