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Precautions and Contraindications: Renal Function : Spironolactone is primarily metabolized by the kidneys, and dosage adjustments may be necessary in patients with impaired renal function to prevent drug accumulation and potential toxicity

PLoS One 12(11):e0187351 Zmock M, Hofbauer S, Schaffner I, Gasselhuber B, Nicolussi A, Soudi M, Pirker KF, Furtmller PG, Obinger C (2015) Independent evolution of four heme peroxidase superfamilies