mineralocorticoid receptor antagonists

Prioritizing SGLT2 Inhibitors Over MRAs as Third-Line Therapy in HFrEF? Nationwide Cohort Shows Lower Mortality with SGLT2 Initiation

By MedXY 12/02/2025

A Danish nationwide cohort study found that initiating SGLT2 inhibitors rather than mineralocorticoid receptor antagonists (MRAs) as the third foundational therapy after RASI and beta‑blocker in HFrEF was associated with lower all‑cause and cardiovascular mortality.

Cardiology Diabetes & Endocrinology news

Normalising Renin After Medical Therapy for Primary Aldosteronism May Lower Cardiovascular Risk — But RCTs Are Needed

By MedXY 11/30/2025

A 2025 systematic review and meta-analysis found that patients with primary aldosteronism whose renin rose after mineralocorticoid receptor antagonist therapy had substantially lower cardiovascular event rates and possibly lower mortality, suggesting renin normalisation as a therapeutic target pending prospective confirmation.

Cardiology Nephrology news

Reassessing the Role of Steroidal Mineralocorticoid Receptor Antagonists in Dialysis Patients: Safety and Efficacy Insights from a Systematic Review and Meta-Analysis

By MedXY 10/11/2025

Steroidal mineralocorticoid receptor antagonists show minimal impact on cardiovascular mortality in dialysis patients, with limited safety concerns and evidence gaps in subgroups and non-steroidal agents.

Clinical Updates Nephrology Specialties

Spironolactone Versus Placebo in Maintenance Dialysis Patients: Insights from the ACHIEVE Trial and Contemporary Evidence

By MedXY 08/27/2025

This review consolidates evidence from the ACHIEVE trial and related studies evaluating spironolactone's efficacy and safety in patients undergoing maintenance dialysis, highlighting lack of cardiovascular benefit and discussing future directions for mineralocorticoid receptor antagonism in this population.

Nephrology Specialties

Spironolactone in Chronic Haemodialysis Patients: Insights from the ALCHEMIST Trial and Updated Meta-Analysis

By MedXY 08/27/2025

The ALCHEMIST trial reveals spironolactone does not improve cardiovascular outcomes in high-risk chronic haemodialysis patients, aligning with a meta-analysis that challenges the benefit of mineralocorticoid receptor antagonists in this population.