What are the indications for aldosterone antagonists in CKD patients?
In patients with CKD, aldosterone antagonists have been shown to decrease urine albumin excretion when added to ACE-I or ARB therapy. However, due to the risk of hyperkalemia and reduction in GFR, they should be used with caution in CKD patients. Plasma potassium levels and kidney function should be monitored closely during the introduction of aldosterone antagonists and during intercurrent illnesses, particularly those associated with a risk of GFR reduction, as occurs with dehydration.