ArticleKidney international2015
Diverse diuretics regimens differentially enhance the antialbuminuric effect of renin-angiotensin blockers in patients with chronic kidney disease.
Article in Kidney international, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Aldosterone antagonists in addition to renin angiotensin system antagonists for preventing the progression of chronic kidney disease.The Cochrane database of systematic reviews · 2020Pooled it
- Impact of Loop Diuretics on Long-Term Kidney Outcome: A Post Hoc Analysis of the STOP-Angiotensin-Converting Enzyme Inhibitor Trial.Kidney360 · 2026Trial
- Chlorthalidone for Hypertension in Advanced Chronic Kidney Disease.The New England journal of medicine · 2021Trial
- A Randomized Trial of Distal Diuretics versus Dietary Sodium Restriction for Hypertension in Chronic Kidney Disease.Journal of the American Society of Nephrology : JASN · 2020Trial
- Urinary markers in heart failure - types, timing and thresholds. European Journal of Heart Failure expert consensus document.European journal of heart failure · 2025Review
- Article
- Mathematical modelling of the influence ofHeliyon · 2024Article
- A Natural Small Molecule Mitigates Kidney Fibrosis by Targeting Cdc42-mediated GSK-3β/β-catenin Signaling.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2024Article
- A Prospective Study of Eplerenone in the Treatment of Patients with Glomerulonephritis.Biomedicines · 2023Article
- Nephrotic syndrome: pathophysiology and consequences.Journal of nephrology · 2023Review
- Thiazide diuretics are back in CKD: the case of chlorthalidone.Clinical kidney journal · 2023Review
- Mathematical modeling of antihypertensive therapy.Frontiers in physiology · 2022Article
- Review
- Renoprotection Provided by Additional Diuretic Treatment in Partially Nephrectomized Ren-2 Transgenic Rats Subjected to the Combined RAS and ETFrontiers in physiology · 2019Article
- Nephrotic Syndrome: Oedema Formation and Its Treatment With Diuretics.Frontiers in physiology · 2018Review
- Capillary Rarefaction Associates with Albuminuria: The Maastricht Study.Journal of the American Society of Nephrology : JASN · 2016Observational
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The addition of spironolactone or hydrochlorothiazide enhances the antialbuminuric effect of renin-angiotensin blockers. However, comparative studies on the effect of different diuretics are lacking. We conducted a prospective randomized crossover study to compare the effects of spironolactone (25 mg/day), hydrochlorothiazide (50 mg/day) without/with amiloride (5 mg/day) on top of enalapril treatment in 21 patients with CKD stages 1-3 and a urinary albumin-to-creatinine ratio (UACR) over 300 mg/g. Treatment periods lasted 4 weeks. The UACR showed a significant reduction with the diuretics: spironolactone, -34% or hydrochlorothiazide without/with amiloride -42% or -56%, respectively. Reduction of the UACR was significantly greater with hydrochlorothiazide without/with amiloride when compared with spironolactone. The percentage of patients who achieved UACR reductions greater than 30% and 50% was greater with hydrochlorothiazide without/with amiloride (81% and 57%, and 81% and 66%, respectively) when compared with spironolactone alone (57% and 28%, respectively). Glomerular filtration rate (GFR), blood pressure, and body weight decreased with the three diuretic regimens. A significant correlation was found between the UACR reduction and GFR and blood pressure changes. Thus, diverse diuretic regimens differentially enhance albuminuria reduction, an effect likely associated with the degree of GFR reduction.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.