{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T04:27:51Z","timestamp":1782534471319,"version":"3.54.5"},"reference-count":36,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["148929"],"award-info":[{"award-number":["148929"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["183777_1"],"award-info":[{"award-number":["183777_1"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","award":["20\/312"],"award-info":[{"award-number":["20\/312"]}],"id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]},{"name":"St. Joseph's Healthcare Hamilton Division of Nephrology"},{"DOI":"10.13039\/100030936","name":"Population Health Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100030936","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005785","name":"Faculty of Medicine, Dalhousie University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005785","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Accelerating Clinical Trials Canada"},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["CS\/20\/2\/34731"],"award-info":[{"award-number":["CS\/20\/2\/34731"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100025520","name":"Medical Research Future Fund","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100025520","id-type":"DOI","asserted-by":"crossref"}]},{"name":"CanSOLVE CKD Network"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Kidney Health Dis"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The mineralocorticoid aldosterone may contribute to the risk of cardiovascular morbidity and mortality in patients receiving maintenance dialysis. Whether spironolactone, a mineralocorticoid receptor antagonist, improves outcomes for patients receiving maintenance dialysis is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To assess the efficacy and safety of spironolactone in patients receiving maintenance dialysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Placebo-controlled, randomized controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Dialysis units<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>Patients receiving maintenance dialysis who are adherent to and able to tolerate spironolactone 25 mg daily during an open-label run-in period of at least 49 days were randomized to spironolactone 25 mg daily or matching placebo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements:<\/jats:title>\n                    <jats:p>Randomized participants were followed for the primary outcome of cardiovascular death or hospitalization due to heart failure. Secondary outcomes include cause specific deaths, hospitalization due to heart failure, all-cause death, all-cause hospitalizations, and severe hyperkalemia. All deaths and possible hospitalizations for heart failure were adjudicated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Eligible participants received open-label spironolactone 25 mg daily for at least 7 weeks during a run-in period. Participants who tolerated and adhered to treatment were randomly allocated to continue spironolactone 25 mg daily or a matching placebo. We followed participants until trial close.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The trial began recruitment in 2018 and concluded recruitment in December 2024. Despite a reduced rate of recruitment during the global COVID-19 pandemic 3565 eligible participants were enrolled of whom 2538 were randomized to spironolactone or placebo from 143 dialysis programs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations:<\/jats:title>\n                    <jats:p>Limited funding and the trial was stopped early due to futility to demonstrate an effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>ACHIEVE was designed as a large, simple trial to determine if spironolactone 25 mg daily prevents cardiovascular mortality and heart failure hospitalizations in patients with kidney failure receiving maintenance dialysis. ACHIEVE demonstrates the possibility of conducting large, international, investigator initiated randomized controlled trials for patients with kidney failure receiving dialysis.<\/jats:p>\n                    <jats:p>NCT03020303.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20543581251348187","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T06:23:18Z","timestamp":1748931798000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["The Aldosterone Blockade for Health Improvement Evaluation in End-Stage Renal Disease (ACHIEVE) Trial: Rationale and Clinical Research Protocol"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8292-2014","authenticated-orcid":false,"given":"Michael","family":"Walsh","sequence":"first","affiliation":[{"name":"Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada"},{"name":"Departments of Medicine and Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada"},{"name":"St. Joseph\u2019s Hospital, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2323-6521","authenticated-orcid":false,"given":"David","family":"Collister","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada"},{"name":"Department of Medicine, University of Alberta, Edmonton, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9187-6187","authenticated-orcid":false,"given":"Martin","family":"Gallagher","sequence":"additional","affiliation":[{"name":"South West Sydney Clinical Campus, UNSW, Liverpool, NSW, Australia"},{"name":"The George Institute for Global Health, UNSW, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick B.","family":"Mark","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janak R.","family":"de Zoysa","sequence":"additional","affiliation":[{"name":"University of Auckland, New Zealand"},{"name":"Renal Services, Waitemat\u0101 Health New Zealand, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Tyrwhitt","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7919-6709","authenticated-orcid":false,"given":"Karthik","family":"Tennankore","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Dalhousie University, Halifax, NS, Canada"},{"name":"Nova Scotia Health, Halifax, NS, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Sola","sequence":"additional","affiliation":[{"name":"Dialysis Unit, CASMU-IAMPP, Montevideo, Uruguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilmar","family":"Reis","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada"},{"name":"Pontificia Universidade Cat\u00f3lica de Minas Gerais, Belo Horizonte, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Xavier","sequence":"additional","affiliation":[{"name":"St. John\u2019s Medical College and Research Institute, Bangalore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell","family":"Villanueva","sequence":"additional","affiliation":[{"name":"Philippine General Hospital, Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen J.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Sultanah Aminah, Johor Bahru, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilo","family":"F\u00e9lix","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n CENIEC, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zuo","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Peking University People\u2019s Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Arici","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Hacettepe University, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivekanand","family":"Jha","sequence":"additional","affiliation":[{"name":"George Institute for Global Health, University of New South Wales, New Delhi, India"},{"name":"School of Public Health, Imperial College, London, UK"},{"name":"Prasanna School of Public Health, Manipal Academy of Higher Education, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Wald","sequence":"additional","affiliation":[{"name":"Division of Nephrology, St. Michael\u2019s Hospital, Toronto, ON, Canada"},{"name":"Department of Nephrology and Hypertension, Tel Aviv Medical Center, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, UNSW, Sydney, NSW, Australia"},{"name":"Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia"},{"name":"Department of Renal Medicine, Concord Repatriation General Hospital, Concord Clinical School, University of Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atiya R.","family":"Faruqui","sequence":"additional","affiliation":[{"name":"St. John\u2019s Medical College and Research Institute, Bangalore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Yuan","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada"},{"name":"Departments of Medicine and Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun Fu","family":"Lee","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada"},{"name":"Departments of Medicine and Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alena","family":"Kuptsova","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Christou","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. J.","family":"Devereaux","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada"},{"name":"Departments of Medicine and Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"For the ACHIEVE Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfq781"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2007020220"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2018050531"},{"issue":"5","key":"e_1_3_2_5_2","first-page":"341","article-title":"Quality of life in patients treated with hemodialysis or peritoneal dialysis: what are the important determinants?","volume":"60","author":"Manns B","year":"2003","unstructured":"Manns B, Johnson JA, Taub K, Mortis G, Ghali WA, Donaldson C. Quality of life in patients treated with hemodialysis or peritoneal dialysis: what are the important determinants? Clinnephrol. 2003;60(5):341-351.","journal-title":"Clinnephrol"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)30752-2"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V115912"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/11.7.1277"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1205624"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60739-3"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1159\/000106803"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1006\/jmcc.2000.1129"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.067918"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1291\/hypres.29.597"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1530\/acta.0.1100207"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs361"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199909023411001"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa030207"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000091405.00772.6E"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab777"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2407107"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2016.04.011"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.12201019"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD013109.pub2"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfg388"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2018.08.034"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.12219"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.12371214"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009492"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2021.106466"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2005.01.010"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3181d99107"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.200077"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2021.101047"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfae156"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.296.11.1377"}],"container-title":["Canadian Journal of Kidney Health and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20543581251348187","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20543581251348187","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20543581251348187","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:21:58Z","timestamp":1777389718000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20543581251348187"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,3]]},"references-count":36,"alternative-id":["10.1177\/20543581251348187"],"URL":"https:\/\/doi.org\/10.1177\/20543581251348187","relation":{},"ISSN":["2054-3581","2054-3581"],"issn-type":[{"value":"2054-3581","type":"print"},{"value":"2054-3581","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,3]]},"article-number":"20543581251348187"}}