Would you continue spironolactone in a patient who has recently progressed to ESKD on HD with oliguria and was diagnosed with primary hyperaldosteronism years ago?

Would you continue spironolactone in a patient who has recently progressed to ESKD on HD with oliguria and was diagnosed with primary hyperaldosteronism years ago?

• Yes, I would continue spironolactone to manage primary hyperaldosteronism, even if there is mild hyperkalemia
• Yes, I would continue spironolactone only if serum potassium levels are within the normal range
• No, I would discontinue spironolactone due to its limited effectiveness in ESKD with minimal urine output
• Other