What do systematic reviews say?

Aldosterone antagonists vs placebo or usual care

Aldosterone antagonists (spironolactone or eplerenone) probably leads to lower death (any cause) compared with control (placebo or standard care) (moderate certainty).

• Aldosterone antagonists for people with chronic kidney disease requiring dialysis 2021 · Cochrane Headline outcomes only
  RR 0.45 [0.3, 0.67]
  9 studies · 1119 participants
  Moderate

Aldosterone antagonists vs placebo or usual care

Aldosterone antagonists (spironolactone or eplerenone) probably leads to lower death (cardiovascular) compared with control (placebo or standard care) (moderate certainty).

• Aldosterone antagonists for people with chronic kidney disease requiring dialysis 2021 · Cochrane Headline outcomes only
  RR 0.37 [0.22, 0.64]
  6 studies · 908 participants
  Moderate

Aldosterone antagonists vs placebo or usual care

Aldosterone antagonists (spironolactone or eplerenone) probably leads to lower cardiovascular and cerebrovascular morbidity compared with control (placebo or standard care) (moderate certainty).

• Aldosterone antagonists for people with chronic kidney disease requiring dialysis 2021 · Cochrane Headline outcomes only
  RR 0.38 [0.18, 0.76]
  3 studies · 328 participants
  Moderate

Aldosterone antagonists vs placebo or usual care

Aldosterone antagonists (spironolactone or eplerenone) showed no clear difference in hyperkalaemia compared with control (placebo or standard care) (low certainty).

• Aldosterone antagonists for people with chronic kidney disease requiring dialysis 2021 · Cochrane Headline outcomes only
  RR 1.41 [0.72, 2.78]
  9 studies · 981 participants
  Low

Aldosterone antagonists vs placebo or usual care

Aldosterone antagonists (spironolactone or eplerenone) probably leads to higher gynaecomastia compared with control (placebo or standard care) (moderate certainty).

• Aldosterone antagonists for people with chronic kidney disease requiring dialysis 2021 · Cochrane Headline outcomes only
  RR 5.95 [1.93, 18.28]
  4 studies · 768 participants
  Moderate

Aldosterone antagonists vs placebo or usual care

• Aldosterone antagonists for people with chronic kidney disease requiring dialysis 2021 · Cochrane Headline outcomes only
  no estimate extracted
  7 studies · 562 participants
  Low