{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:57:33Z","timestamp":1777859853529,"version":"3.51.4"},"reference-count":49,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2015,3,17]],"date-time":"2015-03-17T00:00:00Z","timestamp":1426550400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Renin Angiotensin Aldosterone Syst"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twenty-nine trials (1581 patients) were included. Overall, mineralocorticoid receptor antagonists lowered both systolic and diastolic blood pressure (\u20135.24, 95% confidence interval (CI) \u20138.65, \u22121.82 mmHg; p=0.003 and \u22121.96, 95% CI \u22123.22, \u20130.69 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&lt;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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The long-term effects of mineralocorticoid receptor antagonists on cardiovascular events, mortality and safety need to be established.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1470320315575849","type":"journal-article","created":{"date-parts":[[2015,3,17]],"date-time":"2015-03-17T22:06:31Z","timestamp":1426629991000},"page":"599-613","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Cardiovascular actions of mineralocorticoid receptor antagonists in patients with chronic kidney disease: A systematic review and meta-analysis of randomized trials"],"prefix":"10.1177","volume":"16","author":[{"given":"Khai P","family":"Ng","sequence":"first","affiliation":[{"name":"Department of Nephrology, Queen Elizabeth Hospital and University of Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Arnold","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Queen Elizabeth Hospital and University of Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adnan","family":"Sharif","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Queen Elizabeth Hospital and University of Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paramjit","family":"Gill","sequence":"additional","affiliation":[{"name":"Primary Care Clinical Sciences, University of Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan N","family":"Townend","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Queen Elizabeth Hospital and University of Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles J","family":"Ferro","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Queen Elizabeth Hospital and University of Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,3,17]]},"reference":[{"key":"bibr1-1470320315575849","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60674-5"},{"key":"bibr2-1470320315575849","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2011.505"},{"key":"bibr3-1470320315575849","doi-asserted-by":"publisher","DOI":"10.1111\/j.1755-6686.2010.00166.x"},{"key":"bibr4-1470320315575849","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.09.057"},{"key":"bibr5-1470320315575849","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.107.095489"},{"key":"bibr6-1470320315575849","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2009.184879"},{"key":"bibr7-1470320315575849","doi-asserted-by":"publisher","DOI":"10.1038\/ncpneph1004"},{"key":"bibr8-1470320315575849","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.04750908"},{"key":"bibr9-1470320315575849","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007004.pub3"},{"key":"bibr10-1470320315575849","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"bibr11-1470320315575849","unstructured":"Ng KP, Ferro CJ. 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