For pharmacologic screening to identify hyperaldosteronism in patients after renal transplantation, spironolactone (Soludactone, Searle) was administered intravenously in 12 subjects (mean dose 1.2 g in the course of 3 days). After its administration a decrease in glomerular filtration rate was assessed when measured by chromogen clearance. Simultaneous measurement of creatinine showed no change, nor was there any change in the plasma level and excretion fraction of urea. The decrease in chromogen clearance was due to an increase in plasma level of the chromogen. Thus the decrease in its clearance was an artifact resulting most probably from the reaction of spironolactone metabolites with alkaline picrate, which was used for the determination of chromogen. In addition to the causes of the glomerular filtration rate decrease after spironolactone which have been reported in the literature - volume depletion and direct influence on the kidneys - the possibility of a fictive decrease must be taken into consideration.
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