The results of the CRIB-2 trial, which show that the mineralocorticoid receptor blocker (MRB) spironolactone improves left ventricular mass and aortic stiffness in patients with early stage chronic kidney disease (CKD), provide impetus for large-scale clinical trials to evaluate the effects of this strategy on clinical outcomes. The optimum choice of MRB and its dose, however, remain uncertain given the potential risk of hyperkalemia in patients with CKD.
