Evidence map›Paper›PMID 40470466›Full record

ArticleCanadian journal of kidney health and disease2025

The Aldosterone Blockade for Health Improvement Evaluation in End-Stage Renal Disease (ACHIEVE) Trial: Rationale and Clinical Research Protocol.

Michael Walsh, David Collister, Martin Gallagher, Patrick B Mark, Janak R de Zoysa, Jessica Tyrwhitt, Karthik Tennankore, Laura Sola, Gilmar Reis, Denis Xavier and 15 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian journal of kidney health and disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03020303 (Aldosterone bloCkade for Health Improvement EValuation in End-stage Renal Disease), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT03020303 phase3completednot on this map

Aldosterone bloCkade for Health Improvement EValuation in End-stage Renal Disease

TypeinterventionalSponsorHamilton Health Sciences CorporationRan2017 to 2025Enrolled2,538ConditionsEndstage Renal DiseaseArmsSpironolactone 25Mg Tablet, Placebo Oral Tablet
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Mineralocorticoid Receptor Antagonists in Dialysis.American journal of nephrology · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors.

Michael WalshPopulation Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0001-8292-2014
David CollisterPopulation Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0002-2323-6521
Martin GallagherSouth West Sydney Clinical Campus, UNSW, Liverpool, NSW, Australia.ORCID https://orcid.org/0000-0001-9187-6187
Patrick B MarkSchool of Cardiovascular and Metabolic Health, University of Glasgow, UK.
Janak R de ZoysaUniversity of Auckland, New Zealand.
Jessica TyrwhittPopulation Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada.
Karthik TennankoreDivision of Nephrology, Department of Medicine, Dalhousie University, Halifax, NS, Canada.ORCID https://orcid.org/0000-0002-7919-6709
Laura SolaDialysis Unit, CASMU-IAMPP, Montevideo, Uruguay.
Gilmar ReisDepartments of Medicine and Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Denis XavierSt. John's Medical College and Research Institute, Bangalore, India.
Russell VillanuevaPhilippine General Hospital, Manila, Philippines.
Wen J LiuDepartment of Nephrology, Hospital Sultanah Aminah, Johor Bahru, Malaysia.
Camilo FélixGrupo de Investigación CENIEC, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador.
Li ZuoDepartment of Nephrology, Peking University People's Hospital, Beijing, China.
Mustafa AriciFaculty of Medicine, Hacettepe University, Ankara, Türkiye.
Vivekanand JhaGeorge Institute for Global Health, University of New South Wales, New Delhi, India.
Ron WaldDivision of Nephrology, St. Michael's Hospital, Toronto, ON, Canada.
Amanda Y WangThe George Institute for Global Health, UNSW, Sydney, NSW, Australia.
Atiya R FaruquiSt. John's Medical College and Research Institute, Bangalore, India.
Fei YuanPopulation Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada.
Shun Fu LeePopulation Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada.
Alena KuptsovaPopulation Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada.
Courtney ChristouPopulation Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada.
P J DevereauxPopulation Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada.
ACHIEVE Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: 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. Objective: To assess the efficacy and safety of spironolactone in patients receiving maintenance dialysis. Design: Placebo-controlled, randomized controlled trial. Setting: Dialysis units. Patients: 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. Measurements: 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. Methods: 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. Results: 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. Limitations: Limited funding and the trial was stopped early due to futility to demonstrate an effect. Conclusions: 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.NCT03020303.

Indexed as

dialysiskidney failurespironolactone

Identifiers

PMID40470466
PMCPMC12134517

What Socratic holds

Textmetadata
LicenceCC BY
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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.