Effects of spironolactone on cardiac and residual renal function in patients with peritoneal dialysis

Objective To investigate the effect of spironolactone on cardiac and residual renal function (RRF) in patients with peritoneal dialysis (PD). Methods A total of 96 patients with end-stage renal disease (ESRD) who underwent PD in our hospital from January, 2015 to December, 2016 were randomly divided into experimental group and control group (n=48). The control group was treated with angiotensin converting enzyme inhibitor (ACEI)/agonist receptor antagonist (ARB). The experimental group was treated with spironolactone on the basis of the control group. Left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF), RRF index[residual urea clearance index (KT/V), residual renal creatinine clearance (Ccr)], nutritional anemia, 24 h urine output, peritoneal ultrafiltration and calcium and phosphorus metabolism changes were compared. Results After 6 months and 12 months, the LVMI of the two groups was significantly lower than that before treatment, and the experimental group was lower than the control group. The LVEF of the two groups was significantly higher than that before the treatment, and the test group was higher than the control group (P<0.05). After 6 months and 12 months, the levels of KT/V and Ccr in the control group tend to decrease with statistical significance (P<0.05). There was no significant difference in the levels of KT/V and Ccr in the experimental group (P>0.05). After 6 months and 12 months, the urine output within 24 hours gradually decreased (P<0.05), and the control group decreased more significantly than the experimental group. After 6 months of treatment, the urine output within 24 hours of the experimental group was significantly higher than that of the control group (P<0.05). After 12 months of treatment, the products of serum phosphorus and calcium phosphorus of both groups were lower than those before treatment and the experimental group was lower than the control group. The serum phosphorus was higher than that before treatment, and the experimental group was higher than that before treatment, with significant difference(P<0.05). Conclusion Spironolactone can improve the cardiac function of PD patients, protect patients with RRF, effectively control calcium and phosphorus metabolism, and basically does not affect the nutritional status of patients and peritoneal ultrafiltration, thus worthy of further promotion.