Key result
Mineralocorticoid receptor antagonists may improve survival and reduce cardiovascular risk in patients with end-stage renal disease, though their use is limited by the risk of hyperkalemia.
Why the study?
Do mineralocorticoid receptor antagonists improve cardiovascular outcomes and survival in patients with advanced chronic kidney disease and end-stage renal disease on dialysis?
Do mineralocorticoid receptor antagonists improve cardiovascular outcomes and survival in patients with advanced chronic kidney disease and end-stage renal disease on dialysis?
MRAs offer potential cardiovascular benefits and improved survival for dialysis patients, but their use must be balanced against the significant risk of hyperkalemia.
Patients with advanced chronic kidney disease (CKD), particularly those who have end-stage renal disease (ESRD) and require therapy with dialysis, suffer disproportionately from cardiovascular illnesses. Therapy with mineralocorticoid receptor antagonists (MRAs) effectively reduces cardiac risk in discrete populations. Blockade of the mineralocorticoid receptor carries the potential to reduce blood pressure and to promote favorable remodeling of cardiac structure. Preliminary observations suggest that MRAs can improve survival in patients with ESRD though their widespread adoption is tempered by concerns about effectiveness in patients who have reduced kidney function and the risks of hyperkalemia. This generates a particular conundrum, as sudden cardiac arrest is the predominant cause of death in patients with advanced CKD. In this review, we highlight the potential cardiovascular benefits and review the evident risks of MRAs in patients with ESRD.
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Suthar et al. (2015) conducted a review in End-stage renal disease (ESRD) requiring dialysis. Mineralocorticoid receptor antagonists (MRAs) was evaluated. Mineralocorticoid receptor antagonists may improve survival and reduce cardiovascular risk in patients with end-stage renal disease, though their use is limited by the risk of hyperkalemia.
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