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SHINPEI MORIMOTO, RIYOYU TAKEDA, MOTOTAKA MURAKAMI, Does Prolonged Pretreatment with Large Doses of Spironolactone Hasten a Recovery from Juxtaglomerular-Adrenal Suppression in Primary Aldosteronism?, The Journal of Clinical Endocrinology & Metabolism, Volume 31, Issue 6, 1 December 1970, Pages 659–664, https://doi.org/10.1210/jcem-31-6-659
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Abstract
The effects of preoperative treatment with spironolactone at high doses (300–400 mg/day) for more than 2 months on plasma renin activity and on its response to sodium restriction were studied in 4 patients with primary aldosteronism. The results were compared with those obtained in 2 patients with primary aldosteronism receiving no preoperative spironolactone therapy. All patients treated with spironolactone showed a significant elevation of plasma renin activity, which was further increased with a 4-day period of sodium restriction. In an early stage after removal of an aldosteroneproducing tumor plasma renin activity was markedly increased. In all patients receiving preoperative spironolactone therapy plasma renin activity exaggeratedly responded to restriction of sodium with a rise of serum potassium and augmented natriuresis between the 2nd and 5th postoperative weeks. On the other hand, in 2 patients without preoperative spironolactone therapy plasma renin activity remained at a subnormal level after operation. In a later stage after surgery it gradually returned to a normal level but only slightly increased in spite of increased serum potassium and natriuresis in response to sodium restriction. These findings suggest that preoperative long-term treatment with a high dose of spironolactone in patients with primary aldosteronism can hasten the natural recovery of the ability of the juxtaglomerular apparatus to secrete renin after removal of an aldosteroma, but the functional recovery of remaining adrenal to respond to homeostatic changes lags behind that of the juxtaglomerular apparatus.
