Khan MS, et al. - By performing this systematic review, researchers investigated whether mineralocorticoid receptor antagonists (MRA) affords a safe and effective treatment option for patients with heart failure (HF) and chronic kidney disease (CKD). The relevant studies about patients with HF and decreased renal function (defined as eGFR [estimated glomerular filtration rate] < 60ml/min/1.73m²) were identified from Pubmed, Embase and Cochrane Central databases. This analysis included 7 studies with 5,522 patients. In relation to MRA use, a decrease was evident in the risk of adverse cardiovascular results and/or all-cause death and/or HF hospitalization in the CKD subgroup (eGFR 30-60 ml/min/1.73m²) despite a greater risk of hyperkalemia and higher rates of drug discontinuation, as revealed in post-hoc analyses from randomized controlled trials. Overall, in patients with decreased renal function (eGFR 30-60 ml/min/1.73m), the advantages of MRA use in HF seemed to be consistent.