Impact of Spironolactone on Albuminurea in Patients with Diabetic Nephropathy

Objective To explore the impact of spironolactone on albuminuria in type 2 diabetic patients with diabetic nephropathy.Methods Eighty-six cases of diabetes patients with stage III diabetic nephropathy were randomized into the trial group(Group T,n=44) and the control group(Group C,n=42).Group C were treated with conventional methods,while Group T received additional spironolactone 20 mg daily,both for 12 weeks.Blood pressure,blood glucose[fasting blood glucose(FBG) and 2 h post-prandial blood glucose(2 hPBG)],blood fat[total cholesterol(TC),triglyceride(TG),low density lipoprotein cholestorol(LDL-C)],glycosated Hb A1c(HbA1c),urinary ratio of albumin to creatinine(ACR),electrolytes[serum potassium(SK),serum natrium(SNa)],serum creatinine(SCr) before and after the intervention were analyzed in both groups.Results A total of 38 cases in Group C and 42 cases in Group T accomplished the study.SBP,DBP,FBG,2 hPBG,TG,LDL-C,HbA1c,and SCr were not significantly different in both groups before and after treatment(P0.05).ACR before and after treatment were not significantly different in Group C [(110±111)mg/g vs(82±68)mg/g,P0.05]but significantly different in Group T [(45±47)mg/g vs(85±59)mg/g,P0.05].ACR of Group T was significantly lower than that of Group C at the end the trial(P0.05).Serum TC levels of both two groups decreased after treatment(P0.05),with no difference noted between the two groups(P0.05).SK levels in Group T increased significantly at the end of the study[(4.10±0.46)mmol/L vs(3.82±0.46)mmol/L,P0.05].Conclusion Spironolactone decreases ACR and exhibits independent protection effects in type 2 diabetes patients with diabetic nephropathy.