Hariharasudan Natarajan

Hello everyone. I am Hari, a second-year fellow, lurking while pre-charting for tomorrow's clinic to learn the most recent updates on managing hypertension! #NephJC

Finally, the concurrent results of the ALCHEMIST trial (www.sciencedirect.co...) also showed that spironolactone did not reduce major cardiovascular events in older, high-risk hemodialysis patients. #NephJC
Infographic by @nephroseeker.medsky.socia

Spironolactone is effective in treating hypokalemia among peritoneal dialysis patients - PubMed Spironolactone is safe and effective in treating hypokalemia in PD patients. It is also an effective antihypertensive agent and merits further study in the PD population.

Agree

We do try it very cautiously for hypertension

And we do use it a bunch in PD for managing hypOkalemia pubmed.ncbi.nlm.nih.gov/29125879/

#NephJC

T3b:
But… theoretical reasons do not matter anymore since in this well done, large trial with absolutely no benefit of spironolactone in ESRD. Coupled with the risk of serious hyperkalemia, spironolactone should no longer be used for CV protection in ESRD. #NephJC

T0c:
💔 CV morbidity & mortality in ESRD is driven by:
🔹 Cardiac remodeling, ischemia and myocardial fibrosis
All fueled by chronic pressure–volume overload + inadequate salt/water excretion → relative hyperaldosteronism 🧂 #NephJC

www.imrpress.com/jou...

Hari, a Nephro fellow, No COI. I’m just lurking and learning ☺️ #NephJC

I’m back from hibernation, hehe. Thank you, Cristina!! 😁 #nephJC

Hari, Nephro fellow. No COI. Just lurking! ☺️ #NephJC