Nowak KL, et al. - In this prospective, randomized, controlled, double-blind, clinical trial, researchers investigated if aldosterone antagonism by spironolactone would attenuate vascular dysfunction in patients with early-stage autosomal dominant polycystic kidney disease (ADPKD). Participants were 61 adults aged 20 to 55 years with ADPKD, with estimated glomerular filtration rate ≥ 60 mL/min/1.73 m². These were given spironolactone (maximum dose, 50 mg/d) or placebo for 24 weeks. Assessments were made for change in brachial artery flow-mediated dilation (FMDBA; primary end point) as well as for change in carotid-femoral pulse-wave velocity (CFPWV; secondary end point). The trial was completed by 60 participants. Women constituted 54% of the study population; 84% of the population was non-Hispanic whites. In patients with early-stage ADPKD, systolic blood pressure was attenuated with 24 weeks of aldosterone antagonism, with no changes seen in vascular function.