000			nab a22 7a 4500
999			_c16815 _d16815
003			PC16815
005			20220425111530.0
008			220422b xxu||||| |||| 00| 0 eng d
040			_cH12O
041			_aeng
100			_983 _aMorales Ruiz, Enrique _eNefrología
100			_9417 _aGutiérrez Martínez, Eduardo _eNefrología
100			_9286 _aCaro Espada, Paula Jara _eNefrología
100			_9285 _aSevillano Prieto, Ángel Manuel _eNefrología
100			_93031 _aRojas Rivera, Jorge _eNefrología
100			_91488 _aPraga Terente, Manuel _eNefrología
245	2	0	_aBeneficial long-term effect of aldosterone antagonist added to a traditional blockade of the renin-angiotensin-aldosterone system among patients with obesity and proteinuria. _h[artículo]
260			_bNefrología : publicación oficial de la Sociedad Española Nefrologia, _c2015
300			_a554-61.
500			_aFormato Vancouver: Morales E, Gutiérrez E, Caro J, Sevillano A, Rojas Rivera J, Praga M. Beneficial long-term effect of aldosterone antagonist added to a traditional blockade of the renin-angiotensin-aldosterone system among patients with obesity and proteinuria. Nefrologia. 2015 Nov-Dec;35(6):554-61.
501			_a PMID: 26519114
504			_aContiene 31 referencias
520			_aIntroduction: Over the past decade, obesity has become a risk factor for developing chronic kidney disease. Proteinuria is known to be an independent determinant of the progression of chronic kidney disease, and adipose tissue is a recognized source of components of the renin-angiotensin-aldosterone system (RAAS). Recent studies have shown that plasma aldosterone levels are disproportionately higher in patients with obesity. Drugs that block the RAAS are unable to inhibit aldosterone in the long term. The aim of our study was to analyze the renoprotective effect of an aldosterone antagonist in combination with RAAS blockers in patients with obesity and proteinuric nephropathy. Material and methods: This study is a substudy of previously published study on the renoprotective effect of mineralocorticoid receptor blockers in patients with proteinuric nephropathies. Patients with proteinuria levels >1g/24h who were taking spironolactone and were being treated with other RAAS blockers were divided according to body mass index (BMI) into an obesity group (BMI ≥30kg/m2) and a control group. Results: Seventy-one patients were included in the study, with a mean age of 56.7±15.1 years. More than 50% of the patients in both groups had diabetes. Thirty-two patients were included in the obesity group and 39 were included in the control group. There were no significant differences in renal function, proteinuria, blood pressure, serum potassium levels and the percentage of RAAS blockers in both groups. After a follow-up of 28.9 (14-84) months, there was a 59.4% reduction in proteinuria in the obesity group (2.8±2.1 vs. 1.3±1.6g/24h, p<.05). The reduction in proteinuria was greater than 50% in 22 (68.8%) cases, and the mean blood pressure showed a significant decrease (from 100.6±9 to 92.1±7.4mm Hg, p<.05). The control group showed a 69.6% reduction in proteinuria (1.9±1.4 to 0.8±0.5, p<0.05). The reduction of proteinuria was higher than 50% in 22 (68.8%) cases in obese patients and in 33 (84.6%) cases in non-obese group. Renal function remained stable in both groups during the follow-up. Nine patients (28.1%) in the obesity group experienced gynecomastia. The incidence of hyperkalemia was similar for the 2 groups (6.3%). Conclusion: Aldosterone antagonist treatment in obese patients with proteinuric nephropathies induces a drastic and sustained reduction in proteinuria but not more than the non-obese group. There was a trend toward slowing progression of renal failure with few adverse events.
710			_986 _aServicio de Nefrología
856			_uhttp://pc-h12o-es.m-hdoct.a17.csinet.es/pdf/pc/1/pc16815.pdf _ySolicitar documento
942			_2ddc _cART _n0