ALB and Hyperkalemia: Hou analyzed 16 studies of spironolactone added to routine antidiabetic, renoprotective, and antihypertensive treatment lasting 2–18 months and demonstrated a significant reduction of more than 60% in end-of-treatment 24-h urinary albumin/protein excretion, with the major concern of a more than a fivefold increased risk for hyperkalemia, particularly in those with impaired renal function [40].