Forty percent of patients that require dialysis for kidney failure die within three years
mostly due to heart disease. Heart failure and high blood pressure are common problems in
patients that require dialysis and are key causes of death due to heart disease. Eplerenone
is a drug that is very effective at improving heart failure and reducing blood pressure in
patients that do not require dialysis. There is currently no evidence to tell physicians
whether eplerenone would have similar benefits in patients that require dialysis. This
evidence can only be reliably generated by performing a large scale study. Before such a
study is undertaken, the investigators must determine whether eplerenone will be well
tolerated and safe in patients that require dialysis. The investigators will perform an
initial small trial called the Pilot trial in Hemodialysis patients undergoing Aldosterone
antagoniSm with Eplerenone (PHASE) to determine if eplerenone is a well tolerated, safe
medication to use in a very large, global study that will show whether or not eplerenone
reduces important outcomes for patients like death from heart causes.