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Eplerenone add-on treatment in resistant hypertension in peritoneal dialysis patient. A case report
- Department of Nephrology, Hypertension and Internal Medicine, University Hospital No 1 in Bydgoszcz Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland.
open access
Abstract
Resistant hypertension (RH) is frequently seen in clinical practice in kidney disease patients. Mineralocorticoid receptor antagonists (MRAs) especially spironolactone are highly effective in the management of RH. Eplerenone — highly selective MRA has been also shown to be effective in RH patients but it is rarely used in this clinical condition, especially in kidney disease patients. Eplerenone is mainly recommended in congestive heart failure after myocardial infarction. A case of peritoneal dialysis (PD) patient with RH successfully treated with eplerenone was reported.
Abstract
Resistant hypertension (RH) is frequently seen in clinical practice in kidney disease patients. Mineralocorticoid receptor antagonists (MRAs) especially spironolactone are highly effective in the management of RH. Eplerenone — highly selective MRA has been also shown to be effective in RH patients but it is rarely used in this clinical condition, especially in kidney disease patients. Eplerenone is mainly recommended in congestive heart failure after myocardial infarction. A case of peritoneal dialysis (PD) patient with RH successfully treated with eplerenone was reported.
Keywords
peritoneal dialysis, resistant hypertension, mineralocorticoid receptor antagonists, eplerenone
Title
Eplerenone add-on treatment in resistant hypertension in peritoneal dialysis patient. A case report
Journal
Issue
Article type
Case report
Pages
81-84
Published online
2023-03-21
Page views
2186
Article views/downloads
360
DOI
Bibliographic record
Medical Research Journal 2023;8(1):81-84.
Keywords
peritoneal dialysis
resistant hypertension
mineralocorticoid receptor antagonists
eplerenone
Authors
Rafał Łukasz Donderski
Paweł Stróżecki
- Taniyama Y. Management of hypertension for patients undergoing dialysis therapy. Renal Replacement Therapy. 2016; 2(1).
- Ortega LM, Materson BJ. Hypertension in peritoneal dialysis patients: epidemiology, pathogenesis, and treatment. J Am Soc Hypertens. 2011; 5(3): 128–136.
- Vaios V, Georgianos PI, Liakopoulos V, et al. Assessment and Management of Hypertension among Patients on Peritoneal Dialysis. Clin J Am Soc Nephrol. 2019; 14(2): 297–305.
- Drexler YR, Bomback AS. Definition, identification and treatment of resistant hypertension in chronic kidney disease patients. Nephrol Dial Transplant. 2014; 29(7): 1327–1335.
- Fay KS, Cohen DL. Resistant Hypertension in People With CKD: A Review. Am J Kidney Dis. 2021; 77(1): 110–121.
- Donderski R, Manitius J. The role of aldosterone in kidney diseases and hypertension. Is it worth using mineralocorticoid receptor antagonists in clinical practice? Arterial Hypertension. 2019; 23(1): 1–7.
- Bădilă E, Japie C, Weiss E, et al. The Road to Better Management in Resistant Hypertension-Diagnostic and Therapeutic Insights. Pharmaceutics. 2021; 13(5).
- Tylicki L, Lizakowski S, Rutkowski P, et al. The enhanced renin-angiotensin-aldosteron system pharmacological blockade--which is the best? Kidney Blood Press Res. 2012; 36(1): 335–343.
- Hausmann MJ, Liel-Cohen N. Aldactone therapy in a peritoneal dialysis patient with decreased left ventricular function. Nephrol Dial Transplant. 2002; 17(11): 2035–2036.
- Ito Y, Mizuno M, Suzuki Y, et al. Nagoya Spiro Study Group. Long-term effects of spironolactone in peritoneal dialysis patients. J Am Soc Nephrol. 2014; 25(5): 1094–1102.
- Hamad A, Hussain ME, Elsanousi S, et al. Prevalence and Management of Hypokalemia in Peritoneal Dialysis Patients in Qatar. Int J Nephrol. 2019; 2019: 1875358.
- Langote A, Hiremath S, Ruzicka M, et al. Spironolactone is effective in treating hypokalemia among peritoneal dialysis patients. PLoS One. 2017; 12(11): e0187269.
- Yelken B, Gorgulu N, Gursu M, et al. Effects of spironolactone on residual renal function and peritoneal function in peritoneal dialysis patients. Adv Perit Dial. 2014; 30: 5–10.
- Vazquez-Rangel A, Soto V, Escalona M, et al. Spironolactone to prevent peritoneal fibrosis in peritoneal dialysis patients: a randomized controlled trial. Am J Kidney Dis. 2014; 63(6): 1072–1074.
- Gallacher PJ, Farrah TE, Dominiczak AF, et al. Resistant Hypertension in a Dialysis Patient. Hypertension. 2020; 76(2): 278–287.
- Williams B, MacDonald TM, Morant S, et al. British Hypertension Society's PATHWAY Studies Group. Spironolactone versus placebo, bisoprolol, and doxazosin to determine the optimal treatment for drug-resistant hypertension (PATHWAY-2): a randomised, double-blind, crossover trial. Lancet. 2015; 386(10008): 2059–2068.
- Abolghasmi R, Taziki O. Efficacy of low dose spironolactone in chronic kidney disease with resistant hypertension. Saudi J Kidney Dis Transpl. 2011; 22(1): 75–78.
- Ni X, Zhang J, Zhang P, et al. Effects of spironolactone on dialysis patients with refractory hypertension: a randomized controlled study. J Clin Hypertens (Greenwich). 2014; 16(9): 658–663.
- Gross E, Rothstein M, Dombek S, et al. Effect of spironolactone on blood pressure and the renin-angiotensin-aldosterone system in oligo-anuric hemodialysis patients. Am J Kidney Dis. 2005; 46(1): 94–101.
- Pradhan A, Vohra S, Sethi R. Eplerenone: The Multifaceted Drug in Cardiovascular Pharmacology. J Pharm Bioallied Sci. 2020; 12(4): 381–390.
- Eguchi K, Kabutoya T, Hoshide S, et al. Add-On Use of Eplerenone Is Effective for Lowering Home and Ambulatory Blood Pressure in Drug-Resistant Hypertension. J Clin Hypertens (Greenwich). 2016; 18(12): 1250–1257.
- Yugar-Toledo JC, Modolo R, de Faria AP, et al. Managing resistant hypertension: focus on mineralocorticoid-receptor antagonists. Vasc Health Risk Manag. 2017; 13: 403–411.
- Manolis AA, Manolis TA, Melita H, et al. Eplerenone Versus Spironolactone in Resistant Hypertension: an Efficacy and/or Cost or Just a Men's Issue? Curr Hypertens Rep. 2019; 21(3): 22.