Spironolactone to Prevent the Progression of Vascular Calcification among Peritoneal Dialysis Patients: A Pilot Randomised Controlled Trial (SV-CAPD trial)
Journal Title: Vajira Medical Journal: Journal of Urban Medicine - Year 2022, Vol 66, Issue 6
Abstract
Objective: The purpose of the study was to investigate the efficacy and safety of spironolactone to prevent vascular calcification among peritoneal dialysis patients. Methods: This study was a randomised, double-blinded placebo-controlled trial conducted from August 2018 to December 2020 at Vajira Hospital, Thailand. We randomly assigned peritoneal dialysis patients to receive either 25 mg of spironolactone daily or a placebo for 6 months. Coronary artery calcium scores and laboratory tests were performed and compared at baseline, and 6 months thereafter. Results: Among the 40 patients initially randomised, 34 patients completed the study (17 patients in the spironolactone group and 17 patients in the placebo group). There was no difference in baseline characteristics or laboratory results between both groups. The spironolactone group showed a significant reduction in CACs at 6 months (169.97 AU [IQR 2.34 - 1146.29] to 92.29 AU [IQR 4.83 - 851.1], p=0.05). Compared to placebo, spironolactone had a lower percentage change in CACs (0% [IQR -47.1-14.7] vs 6.06% [IQR -1.9-40.8], p=0.07. However, the change in the absolute progression of CACs was not different (0 AU [IQR -30.5-58.3] in the spironolactone group vs 6.14 AU [IQR -13.9-331.2] in the placebo group). Spironolactone also showed significantly lower serum phosphorus and osteocalcin (3.8 ± 1.3 mg/dL vs 4.8 ± 1.1 mg/dL and 69.0 ng/mL [IQR 41.9-151.5] vs 178.0 ng/mL [IQR 86.8-269.5], p=0.02 and 0.014, respectively). No hyperkalaemia or hypotension was found in either group. Conclusion: Among peritoneal dialysis patients, spironolactone showed a potential benefit to prevent the progression of vascular calcification. Further studies with a larger population and long-term follow-up should be conducted.
Authors and Affiliations
Peerapat Thanapongsatorn Solos Jaturapisanukul Torpong Claimon Surazee Prommool
Keywords
Related Articles
- EP ID EP723935
- DOI http://dx.doi.org/10.14456/vmj.2022.43
- Views 65
- Downloads 0
What is Diabetes Self-Management Education and Support?
Diabetes is a non-communicable disease that has become an epidemic in many countries around the world, with a significant increase in the number of cases. Patients are required to have good glycemic control and maintain...
Efficacy and Adverse Effects of Sodium Phosphate and Polyethylene Glycol When Used in Bowel Preparation prior to Colonoscopy among Patients Admitted at Vajira Hospital
Objective: Bowel preparation is an important process before colonoscopy. Sodium phosphate (NaP) and polyethylene glycol (PEG) are the drugs mainly used in bowel preparation at Vajira Hospital. Since NaP is an osmotic lax...
Provider Satisfaction with the VJR-NMU-N99 Half-Piece Respirator to Prevent Coronavirus Disease-2019
Background: Since the rapid spread of SARs-CoV-2 worldwide, the surgical masks and N95 respirators were needed for personal protective equipment. The VJR-NMU-N99 half-piece respirator has invented. The provider satisfact...
Comparison of Plain Radiograph and Computed Tomography Scan in the Evaluation of Tibial Plateau Fracture
Objective: To compare the accuracy of radiographs (XR) imaging according to computed tomography (CT) scanning in the determination of fracture type (Schatzker classification), characteristics, and to identify indications...
The Implementation of the Quality of Life Development Plan for the Elderly in Bangkok Phase II (2018-2021) into Efficacy Implementation
Objectives: (1) study of the quality of life development plan for the elderly in Bangkok Phase II (2018–2021); (2) study of factors affecting on the quality of life development plan for the effective implementation of th...