Enablement of more persistent use of spironolactone with the administration of newer agents that bind potassium in the gut, the clinical development of nonsteroidal MRAs with sustained BP-lowering action and a more favourable side-effect profile as well as the recently proven BP-lowering efficacy of the thiazide-like diuretic chlorthalidone are three novel therapeutic opportunities for more effective management of hypertension in advanced CKD. Larger phase 3 clinical trials are clearly warranted to fully elucidate whether these therapeutic strategies can also improve kidney failure and cardiovascular outcomes in this high-risk patient population.
Curr Opin Nephrol Hypertens. 2022;31(4):374-379. © 2022 Lippincott Williams & Wilkins