Project Overview

Forty percent of patients that require dialysis die within three years, mostly due to heart disease. Spironolactone is a drug that is very effective at reducing scarring of the heart and might help prevent heart-related deaths in patients with kidney failure. We will determine if spironolactone reduces heart related deaths and hospitalizations due to heart failure.

To determine the effects of spironolactone, we will do a large international study with over 5,000 dialysis patients in several countries. Patients will be randomly assigned to spironolactone or a placebo pill that looks and tastes just like spironolactone but does not have any spironolactone in it. Patients will be followed for about five years, and we will be able to determine how often heart problems occurs in patients who take spironolactone compared to those that take the placebo.

We will also determine whether the spironolactone changes patient’s quality of life or the degree to which they feel unwell or washed out after dialysis. If ACHIEVE shows that spironolactone reduces heart related deaths or hospitalizations, it will broadly change how patients that require dialysis are treated.

ACHIEVE: Aldosterone inhibition and enhanced toxin removal in hemodialysis patients

Project lead(s):

Dr. Michael Walsh, Dr. David Collister

Research theme(s):

Heart Disease

Project video


  • Three week compared to seven week run-in period length and the assessment of pre-randomization adherence: A study within a trial

    Contemporary Clinical Trials

    Collister D, Mbuagbaw L, Guyatt G, Devereaux PJ, Tennankore KK, Reis G, Sola L, Xavier D, Jha V, Gallagher M, Dans AL, Liu W, de Zoysa J, Félix C, Mark PB, Li Z, Tyrwhitt J, Wilkinson J, Sheridan P, Yuan F, Walsh M; ACHIEVE investigators

    Research Project: ACHIEVE

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