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Cardiovascular actions of mineralocorticoid receptor antagonists in patients with chronic kidney disease: A systematic review and meta-analysis of randomized trials.
- Source :
- Journal of the Renin-Angiotensin-Aldosterone System; 2015 Sep, Vol. 16 Issue 3, p599-613, 15p
- Publication Year :
- 2015
-
Abstract
- <bold>Introduction: </bold>The safety and actions of mineralocorticoid receptor antagonists on surrogate markers of cardiovascular disease as well as major patient level cardiovascular end-points in patients with chronic kidney disease are unclear.<bold>Methods: </bold>MEDLINE, EMBASE, Trip Database, Cochrane Central Register of Controlled Trials, Cochrane Renal Group specialized register, Current Controlled Trials and clinicaltrials.gov were searched for relevant trials.<bold>Results: </bold>Twenty-nine trials (1581 patients) were included. Overall, mineralocorticoid receptor antagonists lowered both systolic and diastolic blood pressure (-5.24, 95% confidence interval (CI) -8.65, -1.82 mmHg; p=0.003 and -1.96, 95% CI -3.22, -0.69 mmHg; p=0.002 respectively). There were insufficient data to perform a meta-analysis of other cardiovascular effects. However, a systematic review of the studies included suggested a consistent improvement in surrogate markers of cardiovascular disease. Overall, the use of mineralocorticoid receptor antagonists was associated with an increased serum potassium (0.23, 95% CI 0.13, 0.33 mmol/l; p<0.0001) and higher risk ratio (1.76, 95% CI 1.20, 2.57; p=0.001) of hyperkalemia. Data on long-term cardiovascular outcomes and mortality were not available in any of the trials.<bold>Conclusions: </bold>The long-term effects of mineralocorticoid receptor antagonists on cardiovascular events, mortality and safety need to be established. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 14703203
- Volume :
- 16
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- Journal of the Renin-Angiotensin-Aldosterone System
- Publication Type :
- Academic Journal
- Accession number :
- 109646447
- Full Text :
- https://doi.org/10.1177/1470320315575849