 Cardiovascular disease leads to the death of over half of patients with chronic renal failure CRF but the causes of this vasculopathy remain unknown. Aldosterone is present in the circulation of renal failure patients at high levels and is known to exert damaging effects upon the myocardium, vasculature and autonomic nervous system. Patients will be randomised to determine the effect of chronic treatment with an aldosterone receptor inhibitor on left ventricular mass, diastolic function, arterial stiffness and autonomic function. All of these endpoints are predictors of mortality so that the results of this study may yield information of prognostic value and provide the basis for a future mortality study. 