Cardiac Improvement by Eplerenone Among Patients Under Cyclosporine or Tacrolimus for Kidney Transplantation.

Inclusion Criteria: * Male or female with 18 years old or older. * Transplant patient for at least one year. * Patient on long-term cyclosporine or tacrolimus. * Patient whose clinical situation has been stable for at least 3 months, without major treatment modification and without an episode of acute rejection. * Patient with renal function with a GFR (glomerular filtration rate) greater than or equal to 40 ml/min/1.73m2. * Patient with systolic blood pressure greater than or equal to 110 mmHg, with or without antihypertensive treatment. * Patient with the following echocardiographic abnormalities at baseline : an left ventricular mass \> to 88 g/m2 in females or \> to 102 g/m2 in males and/or left atrial volume \> 34 ml/m2. Exclusion Criteria: * Kidney transplant recipient more than 5 years post-transplantation. * Patient with permanent atrial fibrillation. * Patient with valvular heart disease (grade ≥ 3). * Patient considered to be at very high risk of mortality within the next year. * Patient with documented serum potassium ≥ 5.0 mmol/L within the previous month or receiving long-term potassium-binding resin therapy. * Patient with documented serum bicarbonate \< 20 mmol/L within the previous month, with or without bicarbonate supplementation. * Patient receiving treatment with a mineralocorticoid receptor antagonist or having a formal indication for such treatment. * Patient receiving another potassium-sparing diuretic. * Patient receiving combined treatment with an ACE inhibitor and an angiotensin receptor blocker (each agent being permitted individually). * Patient receiving digoxin therapy. * Left ventricular ejection fraction (LVEF) \< 40% on the baseline echocardiographic assessment. * Planned closure of an existing arteriovenous fistula within the following year. * Known hypersensitivity or allergy to eplerenone or any of its excipients. * Patient with severe hepatic impairment (Child-Pugh class C). * Patient currently receiving treatment with a strong CYP3A4 inhibitor (e.g., itraconazole, ketoconazole, ritonavir, nelfinavir, clarithromycin, telithromycin, or nefazodone). * Patient with known galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption syndrome. * Patient with a contraindication to Kayexalate®: history of hypersensitivity to polystyrene sulfonate resins, obstructive bowel disease, or concomitant treatment with sorbitol-containing laxatives. * Woman of childbearing potential not using an effective method of contraception or planning to become pregnant within the next 12 months. * Patient participating in another interventional clinical study involving modifications to therapeutic management.