Improving heart outcomes in dialysis patients

ACHIEVE - Aldosterone bloCkade for Health Improvement EValuation in End-stage renal disease

About this study

Individuals receiving dialysis are at risk of heart failure and heart-related death. There is an urgent need for treatments that reduce the risk of these problems in patients that require dialysis.

Spironolactone is a medication used to prevent heart failure and related deaths in patients that do not require dialysis. It works by blocking a hormone (aldosterone) in your body that causes high blood pressure and can damage the heart. Although spironolactone is very effective in patients that do not require dialysis, we do not know if spironolactone is effective in dialysis patients. Our research will help determine if spironolactone reduces heart failure and heart related deaths in dialysis patients.

Recruitment criteria


  • Age
    • ≥45 years or
    • ≥18 with a history of diabetes
  • On dialysis ≥ 90 days
    • On either
      • Haemodialysis prescribed at least 2 treatments per week or
      • Peritoneal dialysis prescribed with at least 1 exchange daily
  • Provides informed consent

What’s involved?

  • This trial plans to recruit over 1,000 eligible patients across Australia, New Zealand, Malaysia and China.
  • Participants will be randomly allocated to either take 25mg of spironolactone or identical placebo tablets.
  • Participants will be followed up on a six-monthly basis through face-to-face/telephone interviews or mail-based/electronic questionnaires.