Comparison 1. Aldosterone antagonists (spironolactone or eplerenone) versus control (placebo or usual care).

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1.1 Death (any cause)	9	1119	Risk Ratio (M‐H, Random, 95% CI)	0.45 [0.30, 0.67]
1.2 Death: cardiovascular	6	908	Risk Ratio (M‐H, Random, 95% CI)	0.37 [0.22, 0.64]
1.3 Cardiovascular and cerebrovascular morbidity	3	328	Risk Ratio (M‐H, Random, 95% CI)	0.38 [0.18, 0.76]
1.4 Hyperkalaemia	9	981	Risk Ratio (M‐H, Random, 95% CI)	1.41 [0.72, 2.78]
1.5 Gynaecomastia	4	768	Risk Ratio (M‐H, Random, 95% CI)	5.95 [1.93, 18.28]
1.6 Left ventricular mass	8	633	Std. Mean Difference (IV, Random, 95% CI)	‐0.42 [‐0.78, ‐0.05]
1.7 Left ventricular mass: haemodialysis or peritoneal dialysis	7	435	Std. Mean Difference (IV, Random, 95% CI)	‐0.37 [‐0.79, 0.04]
1.7.1 Haemodialysis only	6	342	Std. Mean Difference (IV, Random, 95% CI)	‐0.40 [‐0.92, 0.12]
1.7.2 Peritoneal dialysis only	1	93	Std. Mean Difference (IV, Random, 95% CI)	‐0.37 [‐0.78, 0.04]
1.8 Ejection fraction	7	458	Mean Difference (IV, Random, 95% CI)	3.15 [‐0.74, 7.04]
1.9 Ejection fraction: haemodialysis or peritoneal dialysis	6	260	Mean Difference (IV, Random, 95% CI)	2.57 [‐2.34, 7.48]
1.9.1 Haemodialysis only	4	156	Mean Difference (IV, Random, 95% CI)	3.13 [‐4.25, 10.51]
1.9.2 Peritoneal dialysis only	2	104	Mean Difference (IV, Random, 95% CI)	2.31 [‐1.99, 6.61]
1.10 Serum potassium	7	519	Mean Difference (IV, Random, 95% CI)	0.21 [‐0.06, 0.47]
1.11 Serum potassium: haemodialysis or peritoneal dialysis	6	321	Mean Difference (IV, Random, 95% CI)	0.06 [‐0.05, 0.18]
1.11.1 Haemodialysis only	5	281	Mean Difference (IV, Random, 95% CI)	0.07 [‐0.05, 0.20]
1.11.2 Peritoneal dialysis only	1	40	Mean Difference (IV, Random, 95% CI)	‐0.01 [‐0.35, 0.33]
1.12 Residual kidney function [urine volume/day]	3	132	Mean Difference (IV, Random, 95% CI)	‐36.23 [‐114.61, 42.15]