Effect of Spironolactone on Diastolic Heart Function in Patients with Chronic Kidney Disease

PURPOSE: The aim of this study was to evaluate the effect of spironolactone on diastolic heart functions in patients with chronic kidney disease by tissue Doppler echocardiography.

MATERIAL and METHODS: Twenty-four patients (11 males, 13 females) were included to the study. The etiology of chronic kidney disease was diabetes mellitus in 14 patients (58%). Biochemical and 24-hour proteinuria analysis, blood pressure measurements, and tissue Doppler echocardiography examination were obtained before the therapy. Spironolactone (25 mg/d) was then added to the treatment. The serum potassium level was measured at the first and fourth weeks. After a period for eight weeks, all the analyses were repeated. The statistical analysis was performed using SPSS version 13.0.

RESULTS: There were significant differences between pretreatment and posttreatment lateral deceleration time, right ventricular deceleration time, and anterior late diastolic velocity (P=0.010, P<0.001, and P=0.046, respectively) by tissue Doppler echocardiography. Systolic and diastolic blood pressure was significantly reduced (P=0.006 and P=0.003, respectively). The serum potassium level was significantly increased (P=0.001). Urinary protein excretion was significantly decreased (P=0.001).

CONCLUSION: This study suggests that spironolactone may improve diastolic heart functions in patients with chronic kidney disease. Hyperkalemia is the most important side effect of treatment. Further studies are needed to determine the efficacy of spironolactone on diastolic heart function.