Author + information
- Arun Kannan, MD∗ (, )
- Chithra Poongkunran, MD and
- Saravanan Balamuthusamy, MD
- ↵∗Department of Internal Medicine, University of Arizona, 1501 North Campbell Avenue, P.O. Box 245212, Tucson, Arizona 85724
Matsumoto et al. (1) have investigated the role of spironolactone in hemodialysis patients. The investigators have noted that spironolactone reduced the risk of both cardiovascular morbidity and mortality in hemodialysis patients. It would be interesting to know the left ventricular mass index and left ventricular ejection fraction in the study population because these 2 parameters have been demonstrated to be objective variables predictive of adverse cardiovascular outcomes in patients with end-stage renal disease (ESRD). The improved cardiovascular outcomes could have been due to an improvement in the aforementioned parameters (2). It would also be worthwhile to know the calcium–phosphorus product and intact parathyroid hormone level in the study population because altered bone mineral metabolism has been associated with increased cardiovascular mortality in ESRD patients. Additionally, the treatment group has a statistically significant increase in baseline serum albumin level; improved nutritional status and decreased protein catabolic rate may have contributed to reduced cardiovascular morbidity and mortality in the study cohort.
Please note: Dr. Balamuthusamy is a consultant to Bard Vascular. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- American College of Cardiology Foundation