Clinical researchers found that giving higher doses of the diuretic spironolactone could safely and effectively treat fluid excess in heart failure patients who did not respond to other diuretics.

The findings are in the journal Annals of Internal Medicine. UT Health San Antonio kidney and cardiovascular specialists conducted a pilot study in 19 patients to show that the higher doses of spironolactone, which prevents reabsorption of excess salt in the kidneys and maintains potassium levels, could be used safely in these very-ill patients, who admit to the hospital with heart failure exacerbation and don’t respond to conventional diuretics.

Spironolactone is usually given to these types of patients in doses of 25-50 milligrams. In this study, the dose was increased to 100 and, at some administrations, even 200 milligrams.

Symptoms

«Heart failure patients come into our care with excessive fluid (salt plus water) on their body, making them short of breath, unable to walk and unable to lie flat,» said Shweta Bansal, M.D., associate professor in the Division of Nephrology at UT Health San Antonio. «They are miserable because of shortness of breath and distension in their abdomen and legs.»

Generally the treatment is a low-salt diet and diuretics. Furosemide (brand name Lasix) is one of the frequently used medications. When patients are admitted to the hospital, they are monitored on this regimen and usually improve.

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Materials provided by University of Texas Health Science Center at San Antonio. Note: Content may be edited for style and length.