Clinical Research Directory

Inclusion Criteria: * Adults aged 18 years or older * Stage 5 chronic kidney disease on maintenance hemodialysis twice weekly * Clinically stable outpatient without clinical signs of volume overload * Resistant hypertension: office systolic blood pressure of 140 mmHg or higher and/or diastolic blood pressure of 90 mmHg or higher despite three antihypertensive drug classes including a diuretic, after lifestyle advice * Written informed consent from the patient or a family member Exclusion Criteria: * Previous spironolactone use * Hyperkalemia * Use of drugs other than routine clinic drugs (antihypertensive drugs, calcium carbonate, and folic acid) * Infection or sepsis, malignancy, or autoimmune disease * Acute complications needing hospital care, such as acute pulmonary edema, severe electrolyte disorders, uremic syndrome, hypertensive urgency or emergency, or hyperglycemic or hypoglycemic crises