Edwards N, Price A, Mehta S, et al. - Findings did not demonstrate superiority of spironolactone over chlorthalidone in decreasing left ventricular mass, blood pressure or arterial stiffness in non-diabetic CKD.

• This is a prospective, randomized, open-label, blinded endpoint (PROBE) study.

• Participants were 154 patients with non diabetic stage 2 and 3 chronic kidney disease in whom spironolactone 25mg was compared with chlorthalidone 25mg once daily for 40 weeks.

• Left ventricular mass regression did not differ significantly between treatment arms; adjusted mean difference for spironolactone vs chlorthalidone was -3.8g at week 40.

• Reduction in office and 24-hour ambulatory blood pressures was seen with both drugs with no significant differences between treatment.

• Spironolactone more frequently resulted in hyperkalemia, but there were no cases of severe hyperkalemia.

• Total 8 patients treated with chlorthalidone showed decline in eGFR >30% vs 2 patients with spironolactone [adjusted relative risk was 0.2 (0.05, 1.1)].