scholarly journals Mineralocorticoid Receptor Antagonism for Cardiovascular Protection in End-Stage Renal Disease: New Data But the Controversy Continues

2015 ◽  
Vol 18 (3) ◽  
pp. 197-199 ◽  
Author(s):  
Panagiotis I. Georgianos ◽  
Pantelis A. Sarafidis ◽  
Vassilios Liakopoulos ◽  
Elias V. Balaskas ◽  
Pantelis E. Zebekakis
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Mineralocorticoid Receptor ◽  
Receptor Antagonism ◽  
Cardiovascular Protection ◽  
Mineralocorticoid Receptor Antagonism ◽  
Stage Renal Disease ◽  
End Stage

Aldosterone-receptor antagonism and end-stage renal disease

2004 ◽  
Vol 6 (4) ◽  
pp. 327-330 ◽  
Author(s):  
Niall McLaughlin ◽  
Todd W. B. Gehr ◽  
Domenic A. Sica
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Receptor Antagonism ◽  
Aldosterone Receptor ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Mineralocorticoid Receptor Antagonists in End-Stage Renal Disease: Efficacy and Safety

2016 ◽  
Vol 41 (1-3) ◽  
pp. 166-170 ◽  
Author(s):  
Andrew S. Bomback
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Mineralocorticoid Receptor ◽  
Left Ventricular ◽  
Efficacy And Safety ◽  
Mineralocorticoid Receptor Antagonists ◽  
Receptor Antagonists ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Mineralocorticoid receptor antagonists (MRAs) that block aldosterone's effects on both epithelial and non-epithelial receptors have become a mainstay of therapy for chronic heart failure. Given that cardiovascular events remain the leading cause of death for patients with end-stage renal disease (ESRD), the question of whether these MRAs can be employed in dialysis patients arises. This review summarizes the rationale for blocking aldosterone in patients with chronic and end-stage kidney disease and surveys the data on both the efficacy and safety of using MRAs in the ESRD population. A small but growing body of literature suggests that use of MRAs by ESRD patients is associated with lower blood pressure, reduced left ventricular (LV) mass, and improved LV ejection fraction. Recently, a large randomized trial found an overall 3-year mortality rate of 6.4% in ESRD patients on spironolactone 25 mg daily vs. 19.7% in ESRD patients on no MRA therapy (p = 0.002), without a significantly increased risk of hyperkalemia.

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