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Mineral receptor antagonists not beneficial for patients undergoing dialysis

Presented by
Dr Lonnie Pyne, McMaster University, Canada
Conference
ERA 2025
According to a meta-analysis, mineral receptor antagonists (MRAs), specifically spironolactone and eplerenone, do not lead to cardiac death or reduce all-cause mortality but increase rates of hyperkalaemia and gynecomastia/breast pain in patients undergoing dialysis. The meta-analysis presented by Dr Lonnie Pyne (McMaster University, Canada) included a total of 19 randomised-controlled trials (9 not part of previous meta-analyses), including the large ACHIEVE (NCT03020303) and ALCHEMIST (NCT01848639) trials. Trial participants were adults with kidney failure receiving dialysis, who were receiving MRAs and either placebo or best standard-of-care as a comparator. Due to considerable heterogeneity among the trials, the analysis focused on trials with low risk of bias. Among ...


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