['Patients with chronic kidney disease (CKD) have high cardiovascular mortality and morbidity associated with increased arterial stiffness. Plasma aldosterone levels are increased in CKD, and aldosterone has been found to increase vascular inflammation and fibrosis. It was hypothesized that aldosterone receptor inhibition with eplerenone could reduce arterial stiffness in CKD stage 3-4.', 'The design was randomized, open, parallel group. Measurements of arterial stiffness markers were undertaken at weeks 1 and 24.', '24 weeks of add-on treatment with 25-50 mg eplerenone or standard medication.', 'Primary outcome parameter was carotid-femoral pulse wave velocity (cfPWV). Secondary outcomes were augmentation index (AIx), ambulatory arterial stiffness index (AASI) and urinary albumin excretion.', 'Fifty-four CKD patients (mean eGFR 36 mL/min/1.73 m(2), SD 11) were randomized. Forty-six patients completed the trial. The mean difference in cfPWV changes between groups was 0.1 m/s (95%CI: -1.0, 1.3), P\u200a=\u200a0.8. The mean difference in AIx changes between groups was 4.4% (0.1, 8.6), P\u200a=\u200a0.04. AASI was unchanged in both groups. The ratio of change in urinary albumin excretion in the eplerenone group compared to the control was 0.61 (0.37, 1.01), P\u200a=\u200a0.05. Four patients were withdrawn from the eplerenone group including three because of possible side effects; one was withdrawn from the control group. Mild hyperkalemia was seen on three occasions and was easily managed.'] Does eplerenone attenuate pulse wave reflection in chronic kidney disease stage 3-4 -- a randomized controlled study?