Background: aldosterone is involved in development of fibrosis in kidney transplantation. Blockade of aldosterone receptor appears to be effective in treatment for chronic allograft dysfunction, reducing proteinuria and glomerular sclerosis.

Materials and methods: retrospective cohort study in kidney transplant recipients from deceased or living donors, performed at Clinic Hospital from University of Campinas – UNICAMP, from February 1990 to August 2016. Inclusion criteria were persistent proteinuria higher than 0.5g/day and spironolactone therapy.

Results: Two hundred fifty-two transplant recipients fulfill the inclusion criteria, 71.8% male, 73% from deceased donor. There was no significant reduction in blood pressure or glomerular filtration rate in the analyzed period. We observed a significant reduction of proteinuria over 36 months of treatment, from 2.1 ± 2.1 at the beginning of treatment to 1.2 ± 1.4 at 36^th month (p<0.05), more pronounced among those with initial proteinuria higher than 3g/day. Therapy was withdrawn in 20 (7.9%) patients because of adverse events, mainly gynecomastia.

Conclusions: Spironolactone therapy was safe and effective in reducing proteinuria, without significant reduction in blood pressure and glomerular filtration rate, and with low incidence of adverse events.

CITATION INFORMATION: Sousa M., Do Valle C., Rivelli G., Camargo L., Zollner R., Mazzali M. Antiproteinuric Effect of Spironolactone in Renal Transplantation: Effectiveness and Clinical Outcomes Am J Transplant. 2017;17 (suppl 3).

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