Does spironolactone improve survival and reduce hypokalemia in patients with severe heart failure?
Spironolactone use is associated with improved survival and less hypokalemia in severe heart failure, provided appropriate surveillance of potassium and creatinine is maintained.
With appropriate surveillance of potassium and creatinine, the use of spironolactone was associated with less hypokalemia and improved survival in patients with severe heart failure even in the setting of moderate hyperkalemia.
Vardeny et al. (2014) studied this question.