CKD will be defined according to estimated glomerular filtration rate (eGFR) with the MDRD formula
eGFR between 30 and 89 ml/min
albumin excretion rates \> 300 mg/24 hours (UACR \> 300 mg/gram) or \> 200 mg/g if already receiving any RAS blockade Patients should be hypertonic stage I or II according to the European guidelines (Chobanian et al. JAMA 2003)
You may not be if
Age \< 18 years
UACR \> 3500mg/g
severe hypertension
pregnancy
unwilling or inability to sign the informed consent
coronary heart disease
systolic blood pressure \< 130 mmHg
additional RAS interfering drugs (ACEis, ARBs, direct renin inhibitors)
25-hydroxy vitamin D levels below 16.6±8.3 pg/ml
1,25-dihydroxy vitamin D 33.1±15.5 pg/ml
Intolerance to eplerenon or an excipient of it:
tablettcore: Lactose-Monohydrat Mikrokristalline Cellulose (E 460) Croscarmellose-sodium (E 468) Hypromellose (E 464) Sodiumdodecylsulfat Talkum (E 553b) Magnesiumstearat (E 470b)
filmcoat
Opadry, yellow:
Hypromellose (E 464) Titandioxid (E 171) Macrogol 400 Polysorbat 80 (E 433) Yellow ironoxide (E 172) Red ironoxide (E 172)
Patients with Serumpotassium \> 5,0 mmol/l at start of the treatment
Patients with severe renal insufficiency (eGFR \<30ml/min./1.73 m2)
Patients with severe liver insufficiency (Child-Pugh class C)
Patients taking potassium saving diuretics, potassium supplements or strong CYP3A4-inhibitors (z. B. Itraconazol, Ketoconazol, Ritonavir, Nelfinavir, Clarithromycin, Telithromycin und Nefazodon)
Clareo Health | The EPOCH Study (Eplerenone on Top of ACE Inhibition in Chronic Kidney Disease Patients With Hypertension)
