螺内酯对肾移植受者肾功能的影响：随机安慰剂对照临床试验。

IF 8.5 1区医学 Q1 UROLOGY & NEPHROLOGY

Clinical Journal of the American Society of Nephrology Pub Date : 2024-06-01 Epub Date: 2024-02-27 DOI:10.2215/CJN.0000000000000439

Line A Mortensen, Bente Jespersen, Anne Sophie L Helligsoe, Birgitte Tougaard, Donata Cibulskyte-Ninkovic, Martin Egfjord, Lene Boesby, Niels Marcussen, Kirsten Madsen, Boye L Jensen, Inge Petersen, Claus Bistrup, Helle C Thiesson

引用次数: 0

摘要

背景：肾脏移植物的长期存活受到进行性间质纤维化和肾小管萎缩的影响。SPIREN试验检验了矿质皮质激素受体拮抗剂螺内酯能稳定肾功能并减轻接受钙调素抑制剂治疗的肾移植患者肾小球屏障损伤的假设：随机、安慰剂对照、双盲临床试验，包括188名肾移植患者。患者随机接受螺内酯或安慰剂治疗，为期三年。测量肾小球滤过率、蛋白尿和肾脏纤维化。主要终点是肾小球滤过率的变化。次要结果为 24 小时蛋白尿、肾脏异体移植纤维化和心血管事件。测量的肾小球滤过率、24 小时蛋白尿和血压每年测定一次。在基线和两年后收集肾活检样本（48 例）。纤维化通过定量立体学进行评估，并根据班夫标准进行分类：结果：除了螺内酯组的异体移植年龄稍大外，其他各组的基线值相当。与安慰剂相比，螺内酯可降低肾小球滤过率（最高可达-7.6（95% CI -10.9;-4.3）毫升/分钟），不受移植后时间和血压的影响，对肾功能曲线没有随时间变化的影响，并在一年后降低了24小时蛋白尿。螺内酯对间质纤维化的发展没有明显影响：结论：肾移植患者在标准治疗的基础上加用螺内酯三年，并不能改善肾功能、长期蛋白尿或间质纤维化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Effect of Spironolactone on Kidney Function in Kidney Transplant Recipients (the SPIREN trial): A Randomized Placebo-Controlled Clinical Trial.

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来源期刊

Clinical Journal of the American Society of Nephrology 医学-泌尿学与肾脏学

CiteScore

12.20

自引率

3.10%

发文量

514

审稿时长

3-6 weeks

期刊介绍： The Clinical Journal of the American Society of Nephrology strives to establish itself as the foremost authority in communicating and influencing advances in clinical nephrology by (1) swiftly and effectively disseminating pivotal developments in clinical and translational research in nephrology, encompassing innovations in research methods and care delivery; (2) providing context for these advances in relation to future research directions and patient care; and (3) becoming a key voice on issues with potential implications for the clinical practice of nephrology, particularly within the United States. Original manuscript topics cover a range of areas, including Acid/Base and Electrolyte Disorders, Acute Kidney Injury and ICU Nephrology, Chronic Kidney Disease, Clinical Nephrology, Cystic Kidney Disease, Diabetes and the Kidney, Genetics, Geriatric and Palliative Nephrology, Glomerular and Tubulointerstitial Diseases, Hypertension, Maintenance Dialysis, Mineral Metabolism, Nephrolithiasis, and Transplantation.