title: Mineralocorticoid receptor blockade reduced oxidative stress in renal transplant recipients: a double-blind, randomized pilot study.
abstract: BACKGROUND
  Previous experimental studies from our laboratory have demonstrated that aldosterone plays a central role in renal ischemic processes. This study was designed to evaluate the effect of mineralocorticoid receptor blockade in renal transplant recipients from living donors.
  
  
  METHODS
  20 adult kidney transplant recipients from living donors were included in a double-blind, randomized, placebo-controlled clinical pilot study that compared spironolactone and placebo. Placebo or spironolactone (25 mg) was administered 1 day before and 3 days posttransplantation. Renal function and urinary kidney injury molecule-1, interleukin-18, and heat shock protein 72 as well as urinary hydrogen peroxide (H2O2) levels were quantified.
  
  
  RESULTS
  No significant differences were seen between the groups studied regarding age, gender, indication for kidney transplantation, residual renal function, renal replacement therapy, or warm and cold ischemia periods. In contrast, spironolactone administration significantly reduced the oxidative stress assessed by the urinary H2O2 excretion, in spite of no differences in renal function or reduction in tubular injury biomarkers.
  
  
  CONCLUSIONS
  The findings of this exploratory study strongly suggest that aldosterone promotes oxidative stress and that the administration of spironolactone reduces the production of urinary H2O2 as a result of lesser formation of surrogate reactive oxygen species secondary to the ischemia-reperfusion phenomenon.
authors: Nephrology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
authors: Marcos
authors: M
authors: Ojeda-Cervantes
authors: Jonatan
authors: J
authors: Barrera-Chimal
authors: Josefina
authors: J
authors: Alberú
authors: Rosalba
authors: R
authors: Pérez-Villalva
authors: Luis Eduardo
authors: LE
authors: Morales-Buenrostro
authors: Norma A
authors: NA
authors: Bobadilla
mesh_terms: D058186:Acute Kidney Injury / Q000517:prevention & control*; D000328:Adult; D015415:Biomarkers / Q000652:urine; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D000451:Mineralocorticoid Receptor Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D018384:Oxidative Stress / Q000187:drug effects*; D010865:Pilot Projects; D011188:Potassium / Q000097:blood; D013148:Spironolactone / Q000494:pharmacology / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D011188:Potassium