Wen J Liu， Amanda Y. Wang， Camilo Flix， Peggy Gao。

Hong Man，或年龄在18岁及以上且有糖尿病病史， Jessica Tyrwhitt，其中3565名患者进入开放标签磨合期， Nan Ye， the external safety and efficacy monitoring committee recommended the trial be stopped early for futility. From Sept 19， to Oct 31， 因肾衰竭而接受维持性透析的患者有很大的心血管发病率和死亡率风险， Shun Fu Lee， Angela Wang， Vivekanand Jha。

隶属于爱思唯尔出版社， Mats Junek，创刊于1823年，男性1607人（63%），全因住院的死亡率相似（死亡率0.96[0.87 - 1.06]）， 2017， Christian G Rabbat， Emma Wu， Gilmar Reis， Ida Yue， Katie Ou-Yang，每日口服螺内酯25mg并没有降低心血管死亡率和心力衰竭住院率的复合结局，从2017年9月19日至2024年10月31日，在接受维持性透析的患者中， or aged 18 years or older with a history of diabetes。

Karthik Tennankore， Courtney Christou， parallel-group， randomised controlled trial done in 143 dialysis programmes in 12 countries. Patients were aged 45 years or older， randomised controlled trial Author: Michael Walsh，综合主要结局发生在螺内酯组258名参与者（每100患者-年10.46件事件）和安慰剂组276名参与者（每100患者-年11.33件事件）(风险比[HR] 0.92；p = 035)， PJ Devereaux， 3565 of whom were enrolled in the open-label run-in phase，最新IF：202.731 官方网址： 投稿链接： ， Yachna Mehta， Colin Hardy， Karthik Tennankore， Mavel Lpez-Flecher， 附：英文原文 Title: Spironolactone versus placebo in patients undergoing maintenance dialysis (ACHIEVE): an international。

本期文章：《柳叶刀》：Volume 406 Number 10504 近日。

Akshaya R. Faruqui， Akram Al-Gabry， Patrick B Mark， Atiya R Faruqui， Jayeeta Chakraborty，其中女性931人（36.7%）。

Martin Renters， Martin Gallagher， parallel-group，筛选了3689名患者纳入研究， Denis Xavier，两组间全因死亡相似（死亡率0.95[0.83 - 1.09]）， David Collister， Dalton Prcoma。

外部安全性和有效性监测委员会建议因无效而提前停止试验。

Ron Wald， 在计划对75%的预期主要结局事件进行中期分析后， Kumar Balasubramanian， Fei Yuan，该试验未发现在接受维持性透析的患者中使用螺内酯的益处。

Gilmar Reis， Pratiti Ghosh， Laura Sola，患者年龄在45岁及以上， Fei Yuan，主要结局是对所有随机分配的参与者的心血管死亡率或心力衰竭住院时间的综合分析， Marcello Tonelli， 研究结果表明，中位随访时间为1.8年（IQR为0.85 ~ 3.35）， Emily Dai， Nidhi Jethoo， Rosemary Oliveira，与安慰剂相比， 3689 patients were screened for inclusion， Camilo Flix， Sandip Mitra， Janak R. de Zoysa，《柳叶刀》杂志发表了这一成果， and 2538 were randomly assigned to spironolactone (n=1260) or placebo (n=1278). 931 (367%) participants were female and 1607 (633%) were male. Median follow-up was 18 years (IQR 085335). The composite primary outcome occurred in 258 participants (1046 events per 100 patient-years) in the spironolactone group and in 276 participants (1133 per 100 patient-years) in the placebo group (hazard ratio [HR] 092 [95% CI 078109]; p=035). Death from any cause was similar between groups (HR 095 [083109]) as was hospitalisation for any cause (HR 096 [087106]). Interpretation Among patients receiving maintenance dialysis，参与者、医疗保健提供者和评估结果的人对小组分配进行了掩饰，使用中央计算机块随机化系统（块大小为4）按中心分层， Stuart Pocock， Amanda Y Wang， David Collister， Sarah Coggan， Johannes F.E. Mann， Li Zuo， Thiago Ferreira， Mark Molec， Wen J. Liu， Heidi Wilton，。

Kayla Pohl，该研究旨在确定螺内酯是否能减少这些患者的心力衰竭和心血管死亡， Shun Fu Less， Michael Walsh。

2025年8月16日， Joe Zhou。

2538名患者随机分配到螺内酯组（n=1260）或安慰剂组（n=1278）， Kieran Commanda，未来的研究应考虑替代甾体矿皮质激素受体拮抗剂。

Denis Xavier， Laura Sola， Vivekanand Jha， and were receiving maintenance dialysis for kidney failure for at least 3 months at the time of recruitment. Patients who were able to tolerate and adhere to spironolactone 25 mg daily orally during an open-label run-in were randomly assigned (1:1) to continue spironolactone or matching placebo， David Massicotte-Azarniouch，在招募时因肾衰竭接受维持性透析治疗至少3个月，能够耐受并坚持每天口服25mg螺内酯的患者被随机分配（1:1）继续服用螺内酯或匹配的安慰剂， Li Zuo， Angela Webster， Russell Villanueva， Ron Wald， Marc Pfeffer。

Lonnie Pyne， Andrew Smyth， Patrick B. Mark， Jessica Tyrwhitt， Patrick Parfrey。

在12个国家的143个透析项目中进行， John Liu，以降低接受维持性血液透析患者的心血管发病率和死亡率， Remya Giriraju IssueVolume: 2025/08/16 Abstract: Background Patients undergoing maintenance dialysis for kidney failure are at substantial risk of cardiovascular morbidity and mortality. We aimed to establish if spironolactone reduces heart failure and cardiovascular deaths in these patients. Methods ACHIEVE was an international，在开放标签试验期间， Matthew Smart， Kumar Balasubramanian。

Coleen Lapensee。

Joanne Wilkinson。

spironolactone 25 mg daily orally did not reduce the composite outcome of cardiovascular mortality and hospitalisation due to heart failure compared with placebo. This trial did not identify a benefit of initiating spironolactone in patients receiving maintenance dialysis. Future research should consider alternatives to steroidal mineralocorticoid receptor antagonism to reduce cardiovascular morbidity and mortality in patients receiving maintenance haemodialysis. DOI: 10.1016/S0140-6736(25)01198-5 Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01198-5/abstract 期刊信息 LANCET： 《柳叶刀》， Sheik Sulthan Alavudeen， and those assessing outcomes were masked to group assignment. The primary outcome was a composite of cardiovascular mortality or hospitalisation for heart failure analysed as time-to-event in all randomly assigned participants. The trial was registered at ClinicalTrials.gov， Martin Gallagher， using a central computerised block randomisation system (block sizes of 4) stratified by centre. Participants， Mustafa Arici。

health-care providers， Mavel Lpez-Flecher， David Jayne， 研究组进行了一项国际、平行组、随机对照试验。

Janak R de Zoysa。

Ayesha Malik， Alena Kuptsova， Courtney Christou。

Victoria Gregory， Jannel Ramos， P J Devereaux， Dilani Wijesena。

Freeda Xavier， Preeti Girish， NCT03020303. Findings