Chronic kidney disease (CKD) has been recognized as a major public health problem with a prevalence of about 843.6 million cases worldwide, and it is one of the few non-communicable diseases with an increase in associated deaths over the past 2 decades.
Patients with impaired kidney function face a high risk of progressive renal function loss that may either lead to complete loss of kidney function requiring dialysis or transplantation, or to increased risk for cardiovascular complications and premature mortality even before life-saving transplantation. From a clinical point of view, CKD manifests with reduced glomerular filtration rate (GFR) and increased albuminuria. Since GFR is significantly affected by high blood pressure, blood pressure-lowering agents typically represent the therapy of first choice. Mineralocorticoid receptor antagonists (MRAs) have also gained a lot of attention, as numerous studies confirmed their anti-albuminuria effects. However, the use of MRAs is rather limited due to the risk of developing life-threatening hyperkalemia.