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Table 3 Concomitant medication and clinical events during follow-up by cohort and MRA treatment duration in the CKD population

From: Patient characteristics and initiation of mineralocorticoid receptor antagonists in patients with chronic kidney disease in routine clinical practice in the US: a retrospective cohort study

Characteristics CKD DKD CKD + HF DKD + HF
No MRA Spironolactone No MRA <  6 months Spironolactone No MRA Spironolactone No MRA Spironolactone
<  6 months ≥ 6 months <  6 months <  6 months <  6 months ≥ 6 months <  6 months ≥ 6 months
(n = 112,730) (n = 869) (n = 481) (n = 75,616) (n = 891) (n = 469) (n = 14,653) (n = 512) (n = 373) (n = 21,144) (n = 808) (n = 458)
Concomitant medications, n (%)
 Angiotensin II receptor blockers 23,232 (20.6) 293 (33.7) 163 (33.9) 22,675 (30.0) 365 (41.0) 194 (41.4) 2915 (19.9) 134 (26.2) 88 (23.6) 5402 (25.5) 248 (30.7) 134 (29.3)
 ACE inhibitors 33,843 (30.0) 322 (37.1) 145 (30.1) 33,084 (43.8) 435 (48.8) 221 (47.1) 5149 (35.1) 265 (51.8) 191 (51.2) 8486 (40.1) 447 (55.3) 232 (50.7)
 Renin inhibitors 671 (0.6) 18 (2.1) 9 (1.9) 889 (1.2) 23 (2.6) 13 (2.8) 99 (0.7) 8 (1.6) 0 (0.0) 245 (1.2) 18 (2.2) 9 (2.0
 β-blockers 36,496 (32.4) 515 (59.3) 261 (54.3) 33,657 (44.5) 611 (68.6) 328 (69.9) 9176 (62.6) 434 (84.8) 323 (86.6) 14,537 (68.8) 706 (87.4) 406 (88.6)
 Calcium-channel blockers 29,305 (26.0) 417 (48.0) 217 (45.1) 26,359 (34.9) 477 (53.5) 253 (53.9) 4625 (31.6) 172 (33.6) 122 (32.7) 7820 (37.0) 351 (43.4) 169 (36.9)
 Vasodilators 12,863 (11.4) 263 (30.3) 126 (26.2) 14,483 (19.2) 349 (39.2) 168 (35.8) 3960 (27.0) 224 (43.8) 145 (38.9) 7827 (37.0) 405 (50.1) 223 (48.7)
 Diuretics 26,812 (23.8) 526 (60.5) 255 (53.0) 27,196 (36.0) 627 (70.4) 315 (67.2) 7647 (52.2) 432 (84.4) 302 (81.0) 13,023 (61.6) 714 (88.4) 385 (84.1)
Clinical events, n (%)
 Reproductive system and breast disordersa 10,517 (9.3) 78 (9.0) 59 (12.3) 7028 (9.3) 117 (13.1) 59 (12.6) 1032 (7.0) 39 (7.6) 29 (7.8) 1532 (7.2) 72 (8.9) 39 (8.5)
 Hyperkalemia 5187 (4.6) 94 (10.8) 53 (11.0) 6890 (9.1) 149 (16.7) 67 (14.3) 1593 (10.9) 78 (15.2) 53 (14.2) 3647 (17.2) 190 (23.5) 75 (16.4)
 Stroke 9821 (8.7) 120 (13.8) 42 (8.7) 9532 (12.6) 179 (20.1) 63 (13.4) 3249 (22.2) 125 (24.4) 78 (20.9) 5307 (25.1) 219 (27.1) 99 (21.6)
 Myocardial infarction 3440 (3.1) 59 (6.8) 26 (5.4) 3975 (5.3) 105 (11.8) 35 (7.5) 2185 (14.9) 118 (23.0) 90 (24.1) 4098 (19.4) 218 (27.0) 124 (27.1)
 Heart failure 3066 (2.7) 99 (11.4) 30 (6.2) 4418 (5.8) 203 (22.8) 39 (8.3) 11,274 (76.9) 470 (91.8) 351 (94.1) 16,511 (78.1) 765 (94.7) 425 (92.8)
 Thrombosis 3594 (3.2) 51 (5.9) 26 (5.4) 2708 (3.6) 58 (6.5) 28 (6.0) 1246 (8.5) 72 (14.1) 32 (8.6) 1834 (8.7) 89 (11.0) 39 (8.5)
  1. ACE acetylcholinesterase, ARB angiotensin II receptor blocker, CKD chronic kidney disease, DKD diabetic kidney disease, HF heart failure, LVH left ventricular hypertrophy, MRA mineralocorticoid receptor antagonist
  2. aPhysical feminization, breast tenderness, gynecomastia, testicular atrophy, reversible infertility, loss of libido and erectile dysfunction, menstrual irregularities