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Objective To investigate the efficacy and safety of hydroxychloroquine (HCQ) versus spironolactone in patients with IgA nephropathy based on sufficient renin-angiotensin-aldosterone system inhibitors (RAASi) treatment. Methods A prospective, non-randomized study was carried out on 172 patients with primary IgA nephropathy admitted in our department from April 2019 to March 2021. They were 56 males and 116 females, at an average age of 37.5±10.7 years. They were divided into HCQ group (n=104) and double RAASi group (n=68) and were followed up for 6 months. The decreasing rate of urine protein creatinine ratio (UPCR) and estimated glomerular filtration rate (eGFR) were compared between the 2 groups during follow-up, and subgroup analysis was conducted to explore the effects of corticosteroids or immunosuppressants on the outcomes. Results Compared with the dual RAASi group, the patients in the HCQ group had worse baseline renal function, lower eGFR and larger proportion of Lee's grades Ⅲ~Ⅳ (P < 0.05). At the 6th month of follow-up, the decreasing rate of UPCR was comparable between the 2 groups (-54.7% vs -52.0%, P=0.551), but the decreasing rate of eGFR was significantly lower in the HCQ group than that in the dual RAASi group (-3.3% vs -11.5%, P < 0.001). In addition, subgroup analysis found that there was no significant difference between HCQ and spironolactone in reducing urine protein, but for those who did not use corticosteroids or immunosuppressants before and after enrollment, those who did not use corticosteroids or immunosuppressants before enrollment but added them after enrollment, and those who used corticosteroids or immunosuppressants before and after enrollment, the HCQ group had a significantly lower eGFR decline rate at 6 months of follow-up than the dual RAAS group (P < 0.05). Moreover, no serious adverse events (SAEs) were observed in either group during the course of the study. Conclusion On the basis of sufficient RAASi treatment, HCQ and spironolactone have similar effects in controlling urine protein level in patients with IgA nephropathy whose urine protein does not reach the target level, and there are no serious adverse events. But HCQ has a significantly better renal protective effect of eGFR than spironolactone.

BackgroundAs a special type of hypertension, resistant hypertension has complex etiology, is difficult to treat, and more likely to lead to target organ damage. Recent studies have found that common triple combination antihypertensive therapies plus low-dose spironolactone could effectively control blood pressure in patients with resistant hypertension, but the efficacy and safety of such treatments need to be further verified due to small scales of these studies.ObjectiveTo perform a systematical review of the efficacy and safety of spironolactone for resistant hypertension.MethodsRandomized controlled trials (RCTs) on spironolactone for resistant hypertension were identified in databases of PubMed, Web of Science, The Cochrane Library, CNKI, VIP, and WanFang Date from inception to May 3rd, 2021. Two researchers separately screened the RCTs, extracted data and assessed the risk bias of eligible studies. Meta-analysis was conducted using RevMan 5.3.ResultsTwenty RCTs were included, nine of which did not report randomization methods, one used randomization based on the sequence of numbers including odd and even numbers of admission (pseudo-randomization) , seven did not report whether blinding was used, four were open-labeled, three described allocation concealment, and one had no complete results with no safety parameters for post-treatment of the controls. Meta-analysis revealed that compared to placebo and blank control groups, spironolactone-treated group had much lower clinic blood pressure, 24-hour ambulatory blood pressure (ABP) , daytime blood pressure and nighttime blood pressure (P

To explore the effect of losartan combined with spironolactone on N'-nitro-L-arginine-methylesterhydrochloride (L-NAME) induced renal fibrosis and ventricular remodeling in hypertensive rats influences. Eight-week-old Wistar rats were selected as the research object, and the hypertension model was induced by giving 0.1% L-NAME drinking water. The rats were divided into three groups according to the random number table: the control group, the induction group and the combined treatment group. The thickness of the interventricular septum and the thickness of the posterior wall of the left ventricle were compared by echocardiography. CODATM8 non-invasive blood pressure system monitors rat heart function. The protein expression of type I collagen, type III collagen and CTGF in rat kidney sections was analyzed by Western blot. Masson's trichromatic staining assesses the deposition of collagen content in kidney tissue. The expressions of rat cardiac hypertrophy markers and transcription factors Atrial natriuretic peptide (ANP) and Brain natriuretic peptide (BNP) were analyzed by RT-PCR. Analyze rat glomerulosclerosis index and albuminuria by immunohistochemistry and immunoturbidimetry. Compared with the control group, the thickness of the ventricular septum and the thickness of the posterior wall of the left ventricle, the MAP and heart/weight ratio, the protein expression of type I collagen, type III collagen and CTGF, the mRNA expression of ANP and BNP, the glomerulosclerosis index and the expression of the model group were compared with those of the control group. Albuminuria and the protein expression of SMA and TGF-β1 all increased significantly, while FS was significantly reduced (P<0.05); The combined treatment group compared the thickness of the ventricular septum and the thickness of the left ventricular posterior wall, the MAP and heart/weight ratio, the protein expression of type I collagen, type III collagen and CTGF, the mRNA expression of ANP and BNP, the glomerular sclerosis index and the whiteness of the model group. Proteinuria and the protein expression of SMA and TGF-β1 were significantly reduced, while FS increased significantly(P<0.05). Losartan combined with spironolactone can reduce the occurrence of cardiac remodeling and renal fibrosis in the L-NAME-induced hypertensive rat model. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical efficacy of spironolactone in the treatment of elderly patients with hypertension and its effect on the levels of serum inflammatory factors. Methods: From June 2017 to December 2018, 144 cases of elderly patients with hypertension were selected and divided into the observation group (80 cases) and control group (64 cases) according to different treatment methods. The control group was treated with nifedipine, and the observation group was treated with spironolactone. Both groups were treated for 4 weeks, and the levels of serum endothelin (ET)-1 and thromboxane (TX)-B2 levels, interleukin (IL)-6 and Soluble Intercellular Adhesion Molecules (SICAM) before and after treatment and clinical efficacy were compared bwteen two groups Results: All patients completed treatment without serious adverse reactions. After treatment, the total effective rate of observation group after treatment were significantly higher than that of the control group (98.8 % vs. 85.9 %, P<0.05). The 24 h systolic blood pressure (SBP) or diastolic blood pressure (DBP), serum ET-1, TX-B2, IL-6 and sICAM-1 levels in the two groups were significantly lower than those before treatment (P<0.05), and the above inDIcators in the observation group were significantly lower than the control group (P<0.05) Conclusion: The clinical efficacy of spironolactone in the treatment of elderly hypertension is significantly better than that of nifedipine, which may be related to the significant inhibition of serum and ET-1, TX-B2, IL-6 and sICAM-1 levels. [ABSTRACT FROM AUTHOR]

Objective: To study the effect of levosimendan combined spironolactone on the serum inflammatory factors levels and ventricular remodeling in patients with chronic heart failure. Methods: 88 cases of patients with chronic heart failure who were treated in our hospital from January 2015 to December 2017 were selected and randomly divided into two groups. The control group was treated with spironolactone alone, while the observation group was treated with levosimendan. The cardiac function indexes(left ventricular end-diastolic diameter, 6-minute walking test, left ventricular ejection fraction and left ventricular end-systolic diameter), serum tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), high sensitivity C-reactive protein(hs-CRP) and N-terminal pro-brain natriuretic peptide(NT-proBNP) levels were observed and compared between the two groups before and after treatment. Results: After treatment, the effective rate of observation group was significantly higher than that of the control group(90.91% vs. 72.73%, P<0.05). After treatment,left ventricular end diastolic diameter, left ventricular end systolic diameter, serum hs-CRP, TNF-α, IL-6 and NT-proBNP levels were significantly lower than those before treatment, while the left ventricular ejection fraction and 6-minute walking test were significantly increased(P<0.05), and the left ventricular end diastolic diameter, left ventricular end systolic diameter, serum levels of hs-CRP, TNF-α,IL-6 and NT-proBNP were significantly lower than those in the control group. The left ventricular ejection fraction and 6-minute walking test were significantly higher than those in the control group(P<0.05). Conclusion: Levosimendan combined with spironolactone may significantly improve its clinical efficacy in the treatment of chronic heart failure, which may be related to the effective improvement of cardiac function, ventricular remodeling and alleviating inflammation. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Food Safety & Quality is the property of Journal of Food Safety & Quality Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To study the clinical efficacy and security of perindopril combined with spironolactone in the treatment of patients with non--adenoma type primary aldosterone. Methods: 62 patients with non--adenoma type primary aldosterone in our hospital were selected and randomly divided into the control group and the observation group with 31 cases in each group. The control group was given 20mg spironolactone orally on the basis of conventional treatment, 3 times a day; while the observation group was additionally given 4mg perindopril orally on the basis of control group, 1 times 1 day. All patients were treated for 3 months, the clinical efficacy, and the changes of blood pressure, heart function, blood potassium and the 6 minute walking test before and after treatment were observed and compared two groups. Results: (1)After treatment, the total clinical effective rate of control group was 74.2%(23/31), which was significantly lower than that of the observation group [93.5%(29/31)](P<0.05); (2) After treatment, the systolic and diastolic blood pressure, LVEDD, LVESD were significantly lower than before treatment(P<0.05), and the LVEE, serumpotassium concentration, 6 minute walking test were significantly higher than those before treatment (P<0.05), and the systolic and diastolic blood pressure, LVEDD, LVESD of observation group were significantly lower than those of the control group (P<0.05), and the LVEE, serum potassium concentration, 6 minute walking test were significantly higher than those of the control group(P<0.05); (3)During the treatment, the incidence of adverse reactions in the control group and observation group was 6.5%(2/31) and 12.9%(4/31), no significant difference was found between two groups(P>0.05). Conclusion: Perindopril combined with spironolactone can significantly improve the clinical efficacy in the treatment of patients with non-adenoma type primary aldosterone, it improve the heart function of patients, and effectively reduce blood pressure with high safety. [ABSTRACT FROM AUTHOR]

Objective To analyze the reason of gynecomastia in a male patient with heart failure and provide safer references for clinical prescriptions. Methods The patient's clinical symptoms, signs and laboratory findings in great detail were learned and the analysis and advice of treatment regimens were given by the clinical pharmacist learned individually. Results Gynecomastia was possible from the result of drugs, the reduction of the dose of the suspicious drug spironolactone and were put forward and adopted. Conclusions As for gynecomastia appeared in the drug treatment process, the clinical pharmacist could analyze and sort out suspicious drugs, then reflect to the prescriber. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the efficacy of benazepril hydrochloride combined with low dose of spironolactone in treatment of diabetic heart disease and heart failure. METHODS: 96 patients with diabetic heart disease and heart failure admitted into Anshan Tiedong District Hospital from Jun. 2016 to Sept. 2017 were selected and divided into observation group and control group via random number table, with 48 cases in each. The control group was given conventional therapy on heart failure, while the observation group was given benazepril hydrochloride combined with low dose of spironolactone based on the control group. The clinical efficacy, left ventricular end-diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF) and incidences of adverse drug reactions of two groups were observed. RESULTS: The total effective rale of observation group was 93. 8% (45/48), which was significantly higher than that of the control group (77. 1 %, 37/48), with statistically significant difference (P < 0. 05); after treatment, the LVEDD of observation group was significantly smaller than that of the control group, while with higher LVEF, with statistically significant differences (P < 0. 05); the incidences of adverse drug reactions of observation group and control group were respectively 8.3% (4/48) and 12.5% (6/48), the difference had no statistical significance (P >0.05). CONCLUSIONS: On basis of conventional therapy, the efficacy of benazepril hydrochloride combined with low dose of spironolactone in treatment of diabetic heart disease and heart failure is remarkable, which can significantly improve patients’ cardiac function. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of spironolactone on the cardiac function,dialysis adequacy and complications in maintenance hemodialysis. Methods Eighty cases of maintenance hemodialysis in the blood purification center of this hospital from September 2015 to September 2016 were selected as the study subjects and divided into the observation group and control group according to the random number table method by the double blindness principle, 40 cases in each group. The observation group was given spironolactone on the basis of routine dialysis, while the control group took the placebo. Then the cardiac function, dialysis adequacy and complications occurrence were compared between the two groups. Results The left ventricular end-diastolic dimension(LVEDD) and left ventricular end systolic dimension(LVESD) after intervention in the observation group were significantly lower than those before intervention and after intervention in the control group,the left ventricular ejection fraction (LVEF) in the observation group was significantly higher than that before intervention and after intervention in the control group, the differences were statistically significant(P<0.05); URR and Kt/V value in the control group had no statistical difference before and after intervention(P>0.05);URR and Kt/V value after intervention in the observation group were significantly higher than those before intervention, the difference was statistically significant(P<0.05); the occurrence rates of hypotension, hypertension and cardiac function failure during dialysis in the observation group were significantly lower than those in the control group, the difference was statistically significant(P<0.05). Conclusion Spironolactone conduces to improve cardiac function and dialysis adequacy in the patients with hemodialysis, and reduces the occurrence rate of complications. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate effects of perindopril combined with spironolactone on neuroendocrine in patients with chronic heart failure. METHODS: 88 patients with chronic heart failure admitted into Henan Tongbai County People’s Hospital from Sept. 2015 to Aug. 2016 were selected to be divided into observation group and control group via the random number table，with 44 cases in each. The control group were treated with standardized treatment of anti-heart failure， while the observation group were given perindopril combined with spironolactone. Changes of neuroendocrine of two groups were compared before and after treatment. RESULTS: After treatment， levels of NTproBNP， Ang II，aldosterone in observation group were significantly lower than those of control group，yet the LVEF was significantly higher than that of control group， with statistically significant difference (P < 0.05). CONCLUSIONS: Perindopril combined with spironolactone in treatment of chronic heart failure can effectively inhibit activation of neuroendocrine system， reduce myocardial cell injury and ventricular remodeling， and promote to the facilitate prognosis. [ABSTRACT FROM AUTHOR]

Objective To study one male patient with cirrhosis for spironolactone induced gynecomastia and promote clinical pharmacists providing better pharmaceutical cares. Methods Based on the patient’s diseases and medication history, clinical pharmacists searched related literature and analyzed the cause of gynecomastia for the patient. Results The patient’s breast pain was relieved and finally disappeared after termination of spironolactone. Therefore, spironolactone was suspected to be the drug to cause gynecomastia. Condusion Clinical pharmacists can improve pharmaceutical cares by carefully monitoring the adverse reactions and selecting appropriate medications. [ABSTRACT FROM AUTHOR]

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To explore the clinical effect of spironolactone combined with metoprolol sustained-release tablets in treatment of elderly patients with chronic heart failure (CHF), and analyze its influence on left ventricular function of patients. Methods: A total of 87 elderly patients with CHF, who were admitted to Wuhan Sixth Hospital from February 2012 to May 2015, were randomly divided into research group (n=45) and control group (n=42). The control group was given conventional therapy, based on which, the research group was added spironolactone combined with metoprolol sustained-release tablets. The treatment lasted 12 weeks. The clinical effect and the changes of left ventricular function before and after treatment were compared between the two groups. Results: The total effective rate in the research group was 91.11%; while the total effective rate in the control group was 69.05%, the difference was statistically significant (P<0.05). After treatment LVEF in the research group was higher than before treatment; LVEDV and LVESV were lower than before treatment, and the in provement degree of the above three indexes in the research group were all better than that in the control group,the differences were statistically significant (P<0.05). Conclusion: Spironolactone combined with metoprolol sustained-release tablets can significantly improve the left ventricular remodeling and left ventricular function in the treatment of elderly patients with CHF, with exact effect, which can be popularized in clinical practice. [ABSTRACT FROM AUTHOR]

Objective: To assess the therapeutic efficacy of central venous catheter placement via abdominal puncture in the treatment of re-fractory ascites. Methods: Thirty - six patients with refractory ascites due to cirrhosis who were unresponsive to albumin supplement and di-uretic treatment and admitted to our hospital from July 2010 to March 2011 were included in this study. Intraperitoneal catheter drainage was performed in these patients, in which generally not more than 800 ml of ascites was drained in the first session and subsequently 1500 -2000 ml of ascites was drained daily; in addition, human albumin (10 gd) was infused, and spironolactone (400 mg/d) and furosemide (160 mg/d) were orally given. Resiults: Reduction in ascites volume, ultrasound examination results, urine volume, and time of stable condition were monitored after 12 days of treatment. Abdominal distension was relieved in all patients after 3 days of treatment. After 12 days of treat-ment, 11 cases (41. 2% ) showed a complete response, 15 cases (41.1% ) showed a partial response, and 4 cases (11.1%) showed no response, with a response rate of 88. 9% . Conclusion: The placement of a central venous catheter in the abdominal cavity reduces the num-ber of punctures and lowers the incidence of hepatorenal syndrome. The central venous catheter offers a convenient, safe, and easy - to - use tool for sustained peritoneal drainage in the treatment of intractable ascites. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of aldosterone (ALD) on the migration of rat hepatic stellate cells (HSC-T6) and its mechanism. Methods HSC-T6 cells were cultured and divided into control group (treated with medium only), ALD group (only 1 nmol/L ALD, 24 hours), spironolactone pre-treated group (a specific inhibitor of ALD receptor 10 nmol/L spironolactone at 1 hours before ALD treatment), Y27632 pre-treated group (a RhoA kinase inhibitor 10 nmol/L Y27632 at 1 hours before ALD treatment). A Transwell TM chamber system was used to observe the change of migration in the different groups. Changes in actin cytoskeletal organization were visualized by fluorescence staining using rhadamin-labeled phalloidin and fluorescence images were recorded using confocal microscopy. The levels of phosphorylated myosinlight chain (p-MLC) and phosphorylated moesin (p-moesin) in the RhoA/ROCK signaling pathway were evaluated by Western blotting in HSC-T6 cells. Results ALD treatment of HSC-T6 resulted in the enhancement of migration, but the effect of ALD-induced migration could be inhibited by spironolactone and Y27632. Stimulation of HSC-T6 with ALD induced a rapid morphological change conconmitant with a robust reorganization of actin cytoskeleton, while the morphological change was suppressed by spironolactone and Y27632. The effect of aldosterone on the activation of HSC migration was mediated by p-MLC and p-moesin protein expressions through the RhoA/ROCK signaling pathway. Spironolactone and Y27632 had the ability to block aldosterone-induced protein expressions in HSC-T6 cells. Conclusion ALD can induce the migration of activated HSC-T6 cells through the activation of the RhoA/ROCK signaling pathway.