Aldosterone and kidney injury in hum There are limited number of studies aimed to evaluate the prevention of AKI with the use of any particular strategy, regard with the use of spironolactone either. However, in a study published by Dr. Brown's group in the United States aimed for decreasing the frequency of postoperative atrial fibrillation (AF) by decreasing the concentration of cytokines and inflammation that has been linked to the development of fibrillation (147 patients), ramipril (151 patients) or spironolactone 25 mg/day (147 patients) were randomly assigned to the study group. Of the secondary objectives of the study, serum K and creatinine levels were considered among other measurements. The frequency of AF in the postoperative period was similar. It should be noted that when analyzing other values such as blood pressure there were no differences between groups, despite being critically ill patients, thus the administration of these drugs did not affect AF. The need for amine use in the postoperative period was similar in the placebo group and the treatment groups. In the postoperative period, an increase in potassium levels was observed in the spironolactone group, but only in one case was necessary to suspend the treatment. The most important aspect of this study is that those patients with spironolactone or ramipril had a lower elevation of creatinine levels compared to the placebo group, which was interpreted as a prevention of renal damage independent of hemodynamic factors. Other observed results were that the group receiving spironolactone had a shorter hospital stay and a reduction in the time of invasive mechanical ventilation.