{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T02:01:21Z","timestamp":1788141681559,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T00:00:00Z","timestamp":1686096000000},"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":["Pediatric Transplantation"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Literature supports the protective role of mineralocorticoid antagonist (MRA) against the renal injury induced by aldosterone in kidney transplant recipients. However, there is limited data available regarding the safety and efficacy of MRAs in pediatric renal transplant patients. Therefore, we aimed to investigate the effect of long\u2010term eplerenone administration in children with chronic allograft nephropathy (CAN).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010six renal transplant children with biopsy\u2010proven CAN, an estimated glomerular filtration rate (eGFR\u2009)\u2009&gt;\u200940\u2009mL\/min per 1.73\u2009m<jats:sup>2<\/jats:sup> and with a significant proteinuria were included. Selected patients were randomly divided into two groups as follows; Group 1 (<jats:italic>n<\/jats:italic>\u2009=\u200910) patients received 25\u2009mg\/day eplerenone and Group 2 (<jats:italic>n<\/jats:italic>\u2009=\u200916) patients did not receive eplerenone for 36\u2009months. Patients were examined in the renal transplant outpatient clinic biweekly for the first month and once a month thereafter. The primary outcome of the patients was compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean eGFR stayed stable in group 1 patients, but significantly decreased in group 2 at 36\u2009months (57.53\u2009\u00b1\u20097.53 vs. 44.94\u2009\u00b1\u20098.04\u2009mL\/min per 1.73\u2009m<jats:sup>2<\/jats:sup>, <jats:italic>p<\/jats:italic>\u2009=\u2009.001). Similarly, spot protein\u2013creatinine ratio was significantly lower in group 1 compared to group 2 patients at 36\u2009months (1.02\u2009\u00b1\u20097.53 vs. 3.61\u2009\u00b1\u20090.53, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Eplerenone associated hyperkalemia was not observed in group 1 patients (4.6\u2009\u00b1\u20090.2 vs. 4.56\u2009\u00b1\u20090.3, <jats:italic>p<\/jats:italic>\u2009=\u2009.713).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The long\u2010term eplerenone administration blunted the chronic allograft nephropathy by maintaining a stable eGFR levels and decreasing urine protein\u2013creatinine ratio. Eplerenone associated hyperkalemia was not observed in our study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14557","type":"journal-article","created":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T17:17:03Z","timestamp":1686158223000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Long\u2010term effect of eplerenone treatment in children with chronic allograft nephropathy"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4361-8508","authenticated-orcid":false,"given":"Esra","family":"Baskin","sequence":"first","affiliation":[{"name":"Department of Pediatric Nephrology Baskent University Faculty of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5739-6590","authenticated-orcid":false,"given":"Meraj Alam","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Baskent University Faculty of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1434-3824","authenticated-orcid":false,"given":"Kaan","family":"G\u00fcllero\u011flu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology Baskent University Faculty of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7528-3557","authenticated-orcid":false,"given":"Binnaz Handan","family":"\u00d6zdemir","sequence":"additional","affiliation":[{"name":"Department of Pathology Baskent University Faculty of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0774-4419","authenticated-orcid":false,"given":"Aysun \u00c7alt\u0131k","family":"Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology Baskent University Faculty of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0294-6874","authenticated-orcid":false,"given":"Meri\u00e7 Yavuz","family":"\u00c7olak","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Baskent University Faculty of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8726-3369","authenticated-orcid":false,"given":"Ayd\u0131ncan","family":"Akdur","sequence":"additional","affiliation":[{"name":"Department of General Surgery Baskent University Faculty of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0993-9917","authenticated-orcid":false,"given":"Ebru Ayvazo\u011flu","family":"Soy","sequence":"additional","affiliation":[{"name":"Department of General Surgery Baskent University Faculty of Medicine  Ankara 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