Key result
Finerenone significantly reduced the risk of cardiovascular mortality (RR 0.86) in individuals with chronic kidney disease and/or type 2 diabetes, representing one of several high-quality benefits of chronic diuretic use despite associated risks like hyperkalemia.
Why the study?
A comprehensive synthesis and critical evaluation of the available evidence on the benefits and risks of chronic diuretic treatment, particularly in older adults, was lacking.
Does chronic diuretic use improve cardiovascular and renal outcomes in adults?
Meta-Analysis (n=1,500,000)
Does chronic diuretic use improve cardiovascular and renal outcomes in adults?
Relative Risk: 0.86 (95% CI 0.82–0.91)
This umbrella review confirms the broad cardiovascular and renal benefits of diuretics, particularly MRAs and finerenone, across heart failure, hypertension, and chronic kidney disease, while highlighting the increased risk of hyperkalemia.
No takes yet. Share an insight, caveat, or question.
Supports targeted use in HF, hypertension, and CKD; leaves open optimal chronic use and deprescribing in frail older adults.
Poelgeest et al. (2025) conducted a meta-analysis in Cardiovascular disease, heart failure, hypertension, chronic kidney disease (n=1,500,000). Chronic diuretic treatment (e.g., finerenone, MRAs, thiazides, torasemide) vs. Placebo, active control, or no treatment was evaluated on Cardiovascular mortality (representative high-quality finding for finerenone) (RR 0.86, 95% CI 0.82-0.91). Finerenone significantly reduced the risk of cardiovascular mortality (RR 0.86) in individuals with chronic kidney disease and/or type 2 diabetes, representing one of several high-quality benefits of chronic diuretic use despite associated risks like hyperkalemia.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: