Do aldosterone antagonists reduce proteinuria and blood pressure in adults with mild to moderate CKD treated with ACEi or ARB?
In adults with mild to moderate CKD on ACEi/ARB therapy, adding aldosterone antagonists improves surrogate markers (proteinuria and blood pressure) but increases hyperkalemia risk, with unproven benefits for hard clinical outcomes.
Aldosterone antagonists reduced proteinuria and blood pressure in adults who had mild to moderate CKD and were treated with ACEi or ARB (or both), but increase hyperkalaemia and gynaecomastia. Whether adding aldosterone antagonists to ACEi or ARB (or both) reduced the risk of major cardiovascular events or ESKD in this population is unknown.
Bolignano et al. (Tue,) studied this question.
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