What are common adverse effects of aldosterone antagonists?

• A. Hyperkalemia and acute kidney injury
• B. Hypokalemia and dehydration
• C. Cough and angioedema
• D. Hypotension only

Answer: (A)

Aldosterone antagonists block the mineralocorticoid receptor in the collecting ducts, reducing sodium reabsorption and water retention while decreasing potassium excretion. This shifts the balance toward potassium retention, making hyperkalemia the most important and common adverse effect. In patients with reduced kidney function or in those taking other meds that raise potassium (like ACE inhibitors, ARBs, or NSAIDs), the risk of hyperkalemia can contribute to acute kidney injury or worsen renal function. So the best-matching adverse effects to remember are hyperkalemia and acute kidney injury.

Other options don’t fit as well because hypokalemia would be the opposite effect (these drugs tend to raise potassium, not lower it); cough and angioedema are classic adverse effects of ACE inhibitors, not aldosterone antagonists; and while hypotension can occur, it’s not the sole or most characteristic issue and misses the key risks of hyperkalemia and kidney injury.