REN and chronic kidney disease: Spironolactone: This aldosterone antagonist is effective in resistant SAH, when there is higher activation of the renin-angiotensin-aldosterone system.214 It is also indicated in primary hyperaldosteronism and POS, because of its antiandrogenic action.214,364 It has a favorable metabolic profile, with low impact on glycemia and lipids, which is relevant in women with increased CVR.214 It is necessary to monitor renal function and potassium levels, mainly in elderly female patients or those with CKD, because of the risk of hyperkalemia.364