Why the study?
Patients with CKD requiring dialysis are at high cardiovascular risk, but the clinical efficacy and harms of aldosterone antagonists in this population remained to be determined.
Do aldosterone antagonists reduce mortality and cardiovascular morbidity in people with chronic kidney disease requiring dialysis?
Population
1446 participants with CKD requiring dialysis across 16 studies
Comparison
Aldosterone antagonists vs placebo or standard care
Design
Systematic review and meta-analysis of 14 parallel and 2 cross-over RCTs
Authors
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Supports aldosterone antagonist use in dialysis CKD; extends RCT evidence to this population despite gynaecomastia risk.
Do aldosterone antagonists reduce mortality and cardiovascular morbidity in people with chronic kidney disease requiring dialysis?
In patients with CKD on dialysis, aldosterone antagonists significantly reduce all-cause and cardiovascular mortality, with an increased risk of gynaecomastia but no significant increase in hyperkalemia.
Hasegawa et al. (2021) studied this question.
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