Table 5.

Randomized trials evaluating the effect of mineralocorticoid receptor antagonists among patients on peritoneal dialysis

AuthorYearNCharacteristicsDesignInterventionFollow-Up, moPrimary OutcomeOverall EffectDetails
Taheri et al. (60)201218Patients on PD with congestive heart failure and LV ejection fraction ≤45%Double-blindSpironolactone (25 mg every other day) versus placebo6Change in LV ejection fractionBetterSpironolactone therapy improved LVEF relative to placebo (25.7%±7.3% versus 33.3%±7.8%; P=0.002)
Ito et al. (58)2014158Patients on PD without congestive heart failure already treated with ACEIs or ARBsOpen-labelAdd-on spironolactone (25 mg/d) versus no treatment24Change in LV mass indexBetterCompared with placebo, add-on spironolactone improved LV mass index at 6, 18, and 24 mo of follow-up
Lin et al. (59)2016253Patients on HD or PD without congestive heart failureOpen-labelAdd-on spironolactone (25 mg/d) versus placebo24Death from cardiovascular events, aborted cardiac arrest, or sudden deathBetterSpironolactone lowered the incidence of the primary outcome by 58% compared with placebo (HR, 42%; 95% CI, 26% to 78%)
  • PD, peritoneal dialysis; LV, left ventricular; LVEF, left ventricular ejection fraction; ACEIs, angiotensin-converting enzyme inhibitors; ARBs, angiotensin receptor blockers; HD, hemodialysis; HR, hazard ratio; 95% CI, 95% confidence interval.