{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:33:45Z","timestamp":1789706025748,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2012,7,15]],"date-time":"2012-07-15T00:00:00Z","timestamp":1342310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetic Medicine"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:sec>\n                    <jats:label\/>\n                    <jats:p>Diabet. Med. 29, e184\u2013e190 (2012)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>\n                      <jats:bold>Aims\u2002<\/jats:bold>\n                      Adding aldosterone receptor blockade to standard renoprotective treatment may provide additional renoprotection in patients with overt nephropathy. We expected an impact of spironolactone in early diabetic nephropathy, and for this hypothesis we studied the effect on markers of glomerular and tubular damage in patients with Type 1 diabetes and persistent microalbuminuria.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>Methods\u2002<\/jats:bold>\n                      A double\u2010blind, randomized, placebo\u2010controlled crossover study in 21 patients with Type 1 diabetes and microalbuminuria using spironolactone 25\u2003mg or placebo once daily, for 60\u2003days added to standard antihypertensive treatment. After each treatment period, the primary endpoint were evaluated: urinary(u)\u2010albumin excretion\/24 hour(h) and secondary endpoints; 24 h blood pressure, glomerular filtration rate (GFR) and markers of tubular damage: urinary liver\u2010type fatty\u2010acid binding protein (LFABP), neutrophil gelatinase associated lipocalin (NGAL) and kidney injury molecule 1 (KIM1).\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>Results\u2002<\/jats:bold>\n                      All patients completed the study. During spironolactone treatment, urinary albumin excretion rate was reduced by 60% (range 21\u201380%), from 90\u2003mg\/24\u2003h to 35\u2003mg\/24\u2003h (\n                      <jats:italic>P\u2003<\/jats:italic>\n                      =\u20030.01). Blood pressure (24\u2003h) did not change during spironolactone treatment (\n                      <jats:italic>P<\/jats:italic>\n                      \u2003&gt;\u20030.2 for all comparisons). The GFR (SD) decreased from 78 (6) mL\/min\/1.73\u2003m\n                      <jats:sup>2<\/jats:sup>\n                      to 72 (6) mL\/min\/1.73\u2003m\n                      <jats:sup>2<\/jats:sup>\n                      (\n                      <jats:italic>P\u2003<\/jats:italic>\n                      =\u20030.003). Urinary liver\u2010type fatty\u2010acid binding protein, neutrophil gelatinase\u2010associated lipocalin and kidney injury molecule 1 did not change during treatment (\n                      <jats:italic>P<\/jats:italic>\n                      \u2003&gt;\u20030.3 for all comparisons). Treatment was well\u2010tolerated, but two patients had severe hyperkalaemia (plasma potassium\u2003=\u20035.7\u2003mmol\/l), which was sufficiently treated with diuretics and dietary intervention.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>Conclusions\u2002<\/jats:bold>\n                      Spironolactone treatment in addition to standard renoprotective treatment lowers urinary albumin excretion in microalbuminuric patients with Type 1 diabetes, and thus may offer additional renoprotection independent of blood pressure.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/j.1464-5491.2012.03585.x","type":"journal-article","created":{"date-parts":[[2012,1,24]],"date-time":"2012-01-24T06:56:40Z","timestamp":1327388200000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":80,"title":["Spironolactone diminishes urinary albumin excretion in patients with type 1 diabetes and microalbuminuria: a randomized placebo\u2010controlled crossover study"],"prefix":"10.1111","volume":"29","author":[{"given":"S. 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