{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:14:58Z","timestamp":1789020898436,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,2,17]],"date-time":"2014-02-17T00:00:00Z","timestamp":1392595200000},"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":["Nephrology"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Objectives<\/jats:title><jats:p>Albuminuria is a robust, validated cardiovascular risk factor. It is a simple and widely available test that was shown to be a powerful and independent predictor of prognosis in chronic heart failure. Mineralocorticoid receptor antagonists may reduce the acute and chronic harmful effects of mineralocorticoid receptor activation on the kidney. The objectives of the trial were to compare the effect of spironolactone versus standard acutely decompensated heart failure (<jats:styled-content style=\"fixed-case\">ADHF<\/jats:styled-content>) therapy on albuminuria and to investigate the role of albuminuria as a prognostic marker in patients with <jats:styled-content style=\"fixed-case\">ADHF<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Secondary analysis of a prospective, interventional study including 100 patients with <jats:styled-content style=\"fixed-case\">ADHF<\/jats:styled-content>. Fifty patients were non\u2010randomly assigned to spironolactone 100\u2009mg\/day plus standard <jats:styled-content style=\"fixed-case\">ADHF<\/jats:styled-content> therapy (intervention group) or standard <jats:styled-content style=\"fixed-case\">ADHF<\/jats:styled-content> therapy alone (control group).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients in control group were older, had higher creatinine and urea levels, and had higher proportion of microalbuminuria (all, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Paired comparison of baseline and day 3 log albuminuria within each group, showed a more pronounced decrease in the intervention group (1.79\u2009\u00b1\u20090.75 to 1.59\u2009\u00b1\u20090.67, <jats:italic>P<\/jats:italic>\u2009=\u20090.003 <jats:italic>vs<\/jats:italic> 1.89\u2009\u00b1\u20090.70 to 1.79\u2009\u00b1\u20090.74, <jats:italic>P<\/jats:italic>\u2009=\u20090.096). In addition, the proportion of patients with normoalbuminuria increased from baseline to day 3 in spironolactone group (20 (40%) to 27 (54%), <jats:italic>P<\/jats:italic>\u2009&lt;\u2009001), accordingly the number of patients in the micro and macroalbuminuria groups was reduced. Day 1 albuminuria was positively correlated with day 1 <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>\u2010terminal pro\u2010brain natriuretic peptide (0.260 [0.105\u20130.758], <jats:italic>P<\/jats:italic>\u2009=\u20090.009).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High\u2010dose spironolactone added to standard <jats:styled-content style=\"fixed-case\">ADHF<\/jats:styled-content> therapy is likely to induce a more pronounced albuminuria decrease and a significant reduction in the proportion of micro and macroalbuminuria.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.12188","type":"journal-article","created":{"date-parts":[[2013,12,17]],"date-time":"2013-12-17T04:01:18Z","timestamp":1387252878000},"page":"149-156","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The role of albuminuria as a non\u2010invasive marker for congestive acutely decompensated chronic heart failure and the spironolactone effect in elderly Portuguese: a non\u2010randomized trial"],"prefix":"10.1111","volume":"19","author":[{"given":"Jo\u00e3o Pedro","family":"Ferreira","sequence":"first","affiliation":[{"name":"Centro Hospitalar do Porto  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1rio","family":"Santos","sequence":"additional","affiliation":[{"name":"Centro Hospitalar do Porto  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Almeida","sequence":"additional","affiliation":[{"name":"Climate Change Impacts, Adaptation and Mitigation Research Group (CC\u2010IAM) Faculdade de Ci\u00eancias Universidade de Lisboa  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Marques","sequence":"additional","affiliation":[{"name":"Centro Hospitalar do Porto  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo","family":"Bettencourt","sequence":"additional","affiliation":[{"name":"Centro Hospitalar de S\u00e3o Jo\u00e3o  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrique","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Centro Hospitalar do Porto  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,2,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.4.421"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/08037050701461084"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-S011"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61378-7"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-6175.2007.06445.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03190906"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2005.05.007"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.112.000152"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199908193410806"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.07.067"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00424-008-0616-0"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1042\/CS20070123"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr170"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.109.881805"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.23.3.377"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2011.02.391"},{"key":"e_1_2_7_19_1","first-page":"S43","article-title":"Glomerular effects of angiotensin II: A reappraisal based on studies with non\u2010peptide receptor antagonists","volume":"11","author":"Ardaillou R","year":"1993","journal-title":"J. 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