The addition of spironolactone to the combination of an ACE inhibitor, and ARB, and a direct renin inhibitor brought about dramatic and sustained reversal of 4-plus proteinuria in a patient with diabetes mellitus and hypertension. Spironolactone may be a valuable addition to the therapeutic armamentarium for such patients, with the caveat that the spironolactone dose should be increased gradually and with frequent monitoring of the serum potassium level.
Harry W Floyd. Dramatic reduction of proteinuria in diabetic nephropathy by the use of spironolactone. Journal of the South Carolina Medical Association (1975). 2012 Aug;108(4):93-4
PMID: 23270101
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