- women of childbearing age without a negative urine pregnancy test, currently pregnant or breastfeeding women; - severe heart failure (nyha4), severe renal failure (egfr < 30 ml/min/1.73 m2), severe liver failure (alt/ast ratio > 5 norms), severe anemia (haemoglobin < 30 g/l) - participating in another clinical trial - severe electrolyte imbalance (hyperkalemia > 5.0 mmol/l, hyponatremia < 120 mmol/l) - hypersensitivity or contraindications to the study drugs (spironolactone and dexamethasone) - renal dialysis - severe uncontrolled diabetes mellitus - patient receiving one of the following medications that cannot be substituted over the trial duration: ace inhibitors, amiloride, eplerenone, cortisone acetate, potassium canrenoate, triamterene

- women of childbearing age without a negative urine pregnancy test, currently pregnant or breastfeeding women; - severe heart failure (nyha4), severe renal failure (egfr < 30 ml/min/1.73 m2), severe liver failure (alt/ast ratio > 5 norms), severe anemia (haemoglobin < 30 g/l) - participating in another clinical trial - severe electrolyte imbalance (hyperkalemia > 5.0 mmol/l, hyponatremia < 120 mmol/l) - hypersensitivity or contraindications to the study drugs (spironolactone and dexamethasone) - renal dialysis - severe uncontrolled diabetes mellitus - patient receiving one of the following medications that cannot be substituted over the trial duration: ace inhibitors, amiloride, eplerenone, cortisone acetate, potassium canrenoate, triamterene