Effect of spironolactone wash‐out on albuminuria after long‐term treatment in individuals with type 2 diabetes and high risk of kidney disease—An observational follow‐up of the PRIORITY study
Authors' conclusion
UACR did not change after discontinuation of long-term treatment with spironolactone. However, an increase in eGFR was observed supporting a haemodynamic effect of spironolactone in the kidneys.
Study context
- Population
- Individuals with T2D and normoalbuminuria but high risk for progression based on urinary proteomics, re-examined ≈6 weeks after the final PRIORITY visit
- Participants
- 115 individuals
- Comparison
- Discontinuation of spironolactone vs placebo
- Spironolactonen = 50
- Placebon = 65reference
- Primary endpoint
- Relative change in geometric mean of UACR between the final visit in PRIORITY (baseline) and follow-up
- Follow-up
- ≈6 weeks after the final visit
Methodological detailswash-out after nested randomised part
- Wash-out after nested randomised part
Primary result
Relative change in geometric mean UACR · follow-up
Relative difference in geometric mean
11%
95% CI −26 to 67
P = 0.60
Change by group
Spironolactone
17%
geometric mean change · 95% CI −12–55
Placebo
5%
geometric mean change · 95% CI −13–26
Between Spironolactone and Placebo
relative difference in geometric mean 11% (95% CI −26 to 67); P = 0.60
As reported in the abstract
Secondary outcomes
Estimated glomerular filtration rate (eGFR), systolic blood pressure (SBP) and serum potassium · follow-up
- eGFR and SBP increased after discontinuation of spironolactone
- all p < 0.05
- SBP increased after placebo discontinuation
- all p < 0.05
- Potassium lower after discontinuation of spironolactone, higher after placebo discontinuation
- all p < 0.05
Original publication
Effect of spironolactone wash‐out on albuminuria after long‐term treatment in individuals with type 2 diabetes and high risk of kidney disease—An observational follow‐up of the PRIORITY study. Diabetes Obes Metab. Published 28 October 2024. doi:10.
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