ArticleKidney medicine2025
Efficacy of Mineralocorticoid Receptor Antagonists on Kidney and Cardiovascular Outcomes in Patients With Chronic Kidney Disease: An Umbrella Review.
Article in Kidney medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed.
- Aldosterone in Diabetic Kidney Disease: From Mineralocorticoid Receptor Antagonism to Aldosterone Synthase Inhibition.International journal of molecular sciences · 2026Review
- Consensus on the management of hypertension in individuals with diabetes by Asian-Pacific Society of hypertension (APSH) & Diabetes Asia Study Group (DASG).Journal of human hypertension · 2026Article
- The Role of Finerenone in Cardiorenal Protection and Urine Albumin-to-Creatinine Ratio Modulation.Kidney international reports · 2026Review
- Mineralocorticoid Receptor Antagonists in Chronic Kidney Disease: Clinical Evidence, Pharmacology, and Drug-Drug Interactions for Personalized Management of Hyperkalemia.International journal of molecular sciences · 2026Review
- Mineralocorticoid Receptor Antagonists in Dialysis.American journal of nephrology · 2026Review
- Diabetic kidney disease within the framework of cardio-kidney-metabolic health: a paradigm shift.Frontiers in pharmacology · 2026Review
- CKDs at the Crossroads: From Failures to Future Therapies.Kidney international reports · 2025Review
- Platelets induce epithelial to mesenchymal transition in renal proximal tubular epithelial cells through TGF-β signaling pathway.Molecular medicine (Cambridge, Mass.) · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Rationale & Objective: To comprehensively summarize the efficacy of mineralocorticoid receptor antagonists (MRAs) to improve kidney and cardiovascular (CV) outcomes in patients with chronic kidney disease (CKD). Study Design: Relevant studies were identified from Medline and Scopus databases from their inception up to August 2023. Setting & Study Populations: Patients with nondialysis or dialysis CKD. Selection Criteria for Studies: Systematic reviews and meta-analyses (SR-MAs) of randomized controlled trials (RCTs) that investigated the efficacy of MRAs on kidney and CV outcomes in patients with nondialysis or dialysis CKD were included in this study. Data Extraction: Characteristics of studies and participants, and treatment effects were extracted. Analytic Approach: Efficacy of MRAs was qualitatively summarized according to types of patients and MRAs. Results: Forty SR-MAs were included. When compared with placebo/usual care, steroidal MRAs (sMRAs) provided significant benefit in decreasing all-cause (pooled RRs of 0.38 [0.22-0.65] to 0.87 [0.77-0.98]) and CV mortality (pooled RRs of 0.34 [0.15-0.75] to 0.46 [0.28-0.76]) only in patients treated with dialysis, when compared with placebo. Nonsteroidal MRAs (nsMRAs) significantly lowered composite CV events in both nondialysis CKD (pooled RRs of 0.86 [0.79-0.94] to 0.92 [0.85-0.99]) and patients with diabetic kidney disease (DKD) (pooled RRs of 0.86 [0.78-0.95] to 0.88 [0.81-0.96]). In addition, nsMRAs showed significant benefit in reducing composite kidney outcomes in patients with either nondialysis CKD or DKD when compared with placebo. However, this efficacy was lower than sodium-glucose cotransporter-2 inhibitors (SGLT2i) in patients with DKD. Moreover, both sMRAs and nsMRAs significantly increased the risk of hyperkalemia in patients with nondialysis CKD and DKD. Limitations: The comparison between nsMRAs and SGLT2i is based on network meta-analyses. Consequently, additional head-to-head RCTs are necessary to confirm the advantages of SGLT2i over nsMRAs. Conclusions: sMRAs offer benefits in reducing all-cause and cardiovascular mortality and composite CV events in patients treated with dialysis. nsMRAs improve kidney outcomes in patients with nondialysis CKD and DKD but increase hyperkalemia risk.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.