Agarwal R, Rossignol P, Romero A, et al. - Given the restriction of using spironolactone for resistant hypertension in patients with chronic kidney disease due to hyperkalemia, researchers examined if the use of the potassium binder patiromer could allow more persistent use of spironolactone in these patients. They conducted this phase 2 multicentre, randomized, double-blind, placebo-controlled study including 295 participants from 62 outpatient centers in ten countries (Bulgaria, Croatia, Georgia, Hungary, Ukraine, France, Germany, South Africa, the UK, and the USA). Participants were randomly assigned to double-blind treatment with either placebo (n = 148) or patiromer (n = 147) in addition to spironolactone and their baseline blood pressure medications. As per outcomes, patiromer allowed more patients to continue treatment with spironolactone with less hyperkalaemia among patients with resistant hypertension and chronic kidney disease. In this patient population, persistent spironolactone enablement has clinical significance for the treatment of resistant hypertension.