ArticleEndocrinology, diabetes & metabolism2025
Efficacy and Safety of Low-Dose Spironolactone in Management of Diabetic Kidney Disease in a Real-World Setting.
Article in Endocrinology, diabetes & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Hypertension associated with systemic therapy for hepatocellular carcinoma and management strategies.Frontiers in pharmacology · 2026Review
- Concerns Regarding Renal Function Claims in Low-Dose Spironolactone Study.Endocrinology, diabetes & metabolism · 2025Article
- Differential cardiometabolic outcomes of leuprolide versus spironolactone in women with polycystic ovary syndrome.Proceedings (Baylor University. Medical Center)Article
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Authors and funding
6 authors.
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Abstract
backgroundAdding spironolactone to renin-angiotensin-aldosterone system (RAAS) blockers has been shown to reduce albuminuria in patients with diabetic kidney disease (DKD). However, the increased risk of hyperkalaemia is a major concern. This study aimed to evaluate the efficacy and safety of low-dose (12.5 mg/day) spironolactone in reducing albuminuria and improving renal function in Iranian adults with DKD.
methodsThis was a pre-post-treatment study of 60 patients with type 2 diabetes, age > 18 years, albuminuria ≥ 30 mg, estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m
resultsAfter 12 weeks of taking 12.5 mg/day spironolactone, there was a statistically significant but modest increase in eGFR (p = 0.042), and a statistically significant decrease was observed in both the U.Alb and uACR (p < 0.001). There was a significant reduction in the mean Cr level (p = 0.003). Systolic blood pressure did not decrease significantly (p = 0.079), but diastolic blood pressure decreased significantly (p = 0.007). Changes in serum potassium levels over time were not significant (p = 0.302). The reduction in albuminuria in patients taking only spironolactone and those taking spironolactone with SGLT2i was not significantly different (p = 0.916 and p = 0.948, respectively).
conclusionsThis study found that adding spironolactone to RAAS blockers effectively reduced albuminuria, mildly increased eGFR, and improved renal outcomes in patients with DKD. Additionally, spironolactone significantly reduced albuminuria, regardless of the concurrent use of SGLT2i.
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