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Table 1 Summary of populations and interventions in included studies. Data are mean ± SD or median (IQR)

From: Effect of mineralocorticoid receptor antagonists on proteinuria and progression of chronic kidney disease: a systematic review and meta-analysis

Study

Kidney disease

No. of patients included

Intervention group

Control group

Co-intervention

Study duration

Baseline eGFR (ml/min/1.73 m2)

Endpoints

Abolghasmi 2011 [24]

CKD with resistant hypertension

41

Spironolactone 25–50 mg

Placebo

multi-drug regime including ACE-I+/−ARB

12 weeks

Not available

BP, potassium, creatinine, urinary sodium

Ando 2014 [28]

CKD with hypertension

314

Eplerenone 50 mg

Placebo

ACE-I+/−ARB of at least 8 weeks duration

1 year

Treatment 67.7 ± 14.3

Control 68.6 ± 13.6

UACR, creatinine, eGFR, urinary L-FABP, 24 h urinary sodium, incidence of cerebrovascular and cardiovascular events

Bianchi 2006 [36]

Non-diabetic CKD (idiopathic GN)

165

Spironolactone 25 mg

ACE-I+/−ARB

ACE-I+/−ARB

1 year

Treatment 62.4 ± 21.9

Control 62.2 ± 19.0

24 h urinary protein, BP, creatinine, eGFR potassium

Boesby 2011 [29]

(XO)

Non-diabetic CKD

40

Eplerenone 25–50 mg

multi-drug regime including ACE-I+/−ARB

multi-drug regime including ACE-I+/−ARB

8 weeks

59 ± 26

24 h urinary albumin, BP, potassium, creatinine clearance

Boesby 2013 [30]

Diabetic and non-diabetic CKD

26

Eplerenone 25–50 mg

ACE-I+/−ARB

ACE-I+/−ARB

24 weeks

36 ± 10

cfPWV, AIx, AASI, 24 h urinary albumin

Chrysostomou 2006a [37]

Diabetic and non-diabetic CKD

41

Spironolactone 25 mg

Placebo as ARB;

Placebo as Spironolactone

ACE-I alone; ACE-I + ARB

3 months

Not available

24 h urinary protein, BP, creatinine, creatinine clearance, potassium

Edwards 2009 [23]

Non-diabetic CKD with no renovascular diagnosis

112

Spironolactone 25 mg

Placebo

ACE-I/ARB

36 weeks

Treatment 49 ± 12

Control 53 ± 11

LVMI, cfPWV, aortic distensibility, AIx, BP

Epstein 2006+ [38]

Diabetic nephropathy

359

Eplerenone 50 mg or 100 mg

Placebo

ACE-I

12 weeks

ACE ± EPL 50

73 (62.1–83.6)

ACE ± EPL 100

75 (62.8–85.9)

Control

74 (60.5–82.2)

UACR, potassium, BP, eGFR

Guney 2009 [25]

Non-diabetic CKD

24

Spironolactone 25 mg

ACE-I+/−ARB

ACE-I+/−ARB

6 months

Treatment 63.0 ± 22.71

Control 56.3 ± 35.6

UPCR, urinary TGF-β1, eGFR, creatinine, potassium, BP, aldosterone

Mehdi 2009 [22]

Diabetic nephropathy

81

Spironolactone 25 mg

Placebo or ARB

ACE-I

48 weeks

Not available

UACR, BP, creatinine clearance, potassium

Nielsen 2012 [26]

(XO)

Diabetes with microalbuminuria

21

Spironolactone 25 mg

Placebo

ACE-I/ARB

60 days

Not available

24 h urinary albumin, BP, GFR, urinary L-FABP, urinary NGAL, urinary KIM-1

Rossing 2005 [39]

(XO)

Diabetic nephropathy

20

Spironolactone 25 mg

Placebo

ACE-I+/−ARB

8 weeks

Not available

24 h urinary albumin, BP, GFR

Saklayen 2008 [43]

(XO)

Diabetic nephropathy

24

Spironolactone 25–50 mg

Placebo

ACE-I/ARB

3 months

Treatment 61.9 ± 23.4

Control 54.4 ± 20.1

BP, creatinine, potassium, UPCR

Schjoedt 2005 [40]

(XO)

Diabetic nephropathy

20

Spironolactone 25 mg

Placebo

ACE-I+/−ARB

2 months

Not available

24 h urinary albumin, BP, GFR

Tylicki 2008 [41]

(XO)

Non-diabetic CKD

18

Spironolactone 25 mg

ACE-I + ARB

ACE-I + ARB

8 weeks

107.8 (93–140.9)

24 h urinary protein, BP, creatinine, potassium, PRA, urinary NAG, urinary PIIINP

Tylicki 2012 [31]

(XO)

Non-diabetic CKD

18

Eplerenone 50 mg

ARB + Aliskiren

ARB

8 weeks

Not available

UACR, BP, creatinine clearance, potassium

van den Meiracker 2006 [42]

Diabetic nephropathy

53

Spironolactone 25–50 mg

Placebo

ACE-I/ARB

1 year

Treatment 93.1 ± 45

Control 66.3 ± 35.1

24 h urinary protein, BP, creatinine, eGFR, potassium

Wang 2013 [34]

Diabetic and non-diabetic CKD

208

Spironolactone 20 mg

multi-drug regime including ACE-I+/−ARB

multi-drug regime including ACE-I+/−ARB

16 weeks

Treatment 65.8 ± 22.2

Control 66.5 ± 24.3

24 h urinary protein, creatinine, potassium, eGFR, BP, aldosterone

Ziaee 2013 [27]

Diabetes with microalbuminuria

60

Spironolactone 25 mg

ACE-I

ACE-I

12 weeks

Treatment 79.8 ± 18

Control 82.5 ± 19.1

UACR, BP, potassium, eGFR

  1. UACR urine albumin:creatinine ratio, UPCR urine protein:creatinine ratio, ACE-I angiotensin converting enzyme inhibitor, ARB angiotensin receptor blocker, CKD chronic kidney disease, NG glomerulonephritis, L-FABP liver-type fatty acid binding protein, XO crossover study design, cfPWV carotid-femoral pulse wave velocity, AIx augmentation index, AASI ambulatory arterial stiffness index, LVMI left ventricular mass index, TGF-β1 transforming growth factor-β1, NGAL neutrophil gelatinase associated lipocalin, KIM-1 kidney injury molecule-1, PRA plasma renin activity, NAG n-acetyl-β-D-glucosaminidase, PIIINP amino-terminal propeptide of type III procollagen, athis study had 4 arms +this study had 3 arms