The Effect of Eplerenone on the Evolution of Vasculopathy in Renal Transplant Patients.

Inclusion criteria

• Men or women ≥ 50 years of age;
• Patient who had a kidney transplant at least one year prior to inclusion;
• Patient on cyclosporine;
• Patient whose clinical-biological state has been stable for at least 3 months: no change in treatment with an impact on blood pressure (excluding immunosuppressive drug) for 3 months, no acute rejection diagnosed within 3 months;
• Patient with a glomerular filtration rate estimated according to the formula CKD-EPI ≥30mL/min/1.73m2;
• Patient with a peripheral PAS≥110mmHg, irrespective of the presence or not of an antihypertensive therapy (including ACE inhibitors or sartan) ;
• Patient with signed informed consent;
• Patient affiliated with or beneficiary of a social security system.

Exclusion criteria

• Patient with documented kalemia ≥ 5mmol/L in the last 15 days;
• Patient undergoing mineralocorticoid receptor antagonism or with a formal indication to receive this treatment;
• Bicarbonate blood level <20mmol/L with or without documented supplementation in the last 15 days.
• Indication for a combination of ACE inhibitor and sartan (each of which is authorized separately);
• Patient under another potassium sparing diuretics;
• Patient under digoxine;
• Sodium polystyrene sulfonate contraindication;
• Known hypersensitivity or allergy to eplerenone and its excipients;
• Patient with severe hepatic impairment (Child-Pugh Class C);
• Patient under CYP3A4 inhibitor;
• know intolerance to Galactose, a Lapp lactase deficiency or galactose malabsorption syndrome;
• Patient participating in other interventional research;
• Woman with a desire of pregnancy within 15 months;
• Woman of childbearing age without effective contraception;
• Persons referred to in Articles L. 1121-5, L. 1121-7 and L1121-8 of the Public Health Code :
• Pregnant women, parturient women or nursing mothers ;
• Adult person subject to a legal protection measure (guardianship, curator, judicial safeguard);
• Adults person who is unable to give consent and who is not subject to a legal protection measure;
• Persons deprived of their liberty by a judicial or administrative decision;
• Persons subject to psychiatric care pursuant to articles L. 3212-1 and L. 3213-1.