Trials testing the ability of mineralocorticoid receptor antagonists to reduce arrhythmic risk in patients with ESKD are lacking, but observational data have suggested a decreased risk of new-onset atrial fibrillation among those prescribed, compared with those not prescribed, spironolactone.35 In this study, which was limited by baseline between-group differences in event rates and low overall event rates, an effect of spironolactone on atrial fibrillation was not detected. This evidence concerns the gene NR3C2 and atrial fibrillation.