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Aldosterone correlates with CKD progression, increased risk of ESKD

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August 9, 2022

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Disclosure: Verma reports independent consulting fees for this work from Corcept Therapeutics, Mineralys, and HRA Pharma.


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According to data published in , aldosterone is associated with an increased risk of chronic kidney disease progression and the development of end-stage renal disease. European Heart Journal.

Moreover, this correlation is independent of whether the patient has diabetes.



Infographic showing progression of CKD
Also, people in the highest quartile of serum aldosterone had a 45% increased risk of developing CKD compared to those in the lowest quartile. Data are from Verma A et al. Eur Heart J. 2022; doi:10.1093/eurheartj/ehac352.

“In a recent randomized controlled trial, fine lenone Effective in slowing CKD progression and adverse cardiovascular outcomes in patients with chronic kidney disease and diabetes. However, the role of aldosterone in this process has not been directly investigated and levels of the hormone have not been measured. Ashish Verma, MD, An assistant professor at the Boston University School of Medicine said in a press release: “Excess levels of aldosterone are common but largely unrecognized, so one reason finerenone has been so effective in reducing the risk of developing CKD is that the unrecognized high levels of the hormone I assumed it was because I was being treated.”

Researchers studied 3,680 CKD patients in a chronic renal failure cohort study to determine the association between serum aldosterone and kidney disease. Serum aldosterone measurements were obtained at baseline and none of the patients were on aldosterone antagonists.

For a median of nearly 10 years, patients visited the clinic annually and were followed by telephone every 6 months. Using the Cox proportional hazards model, researchers determined the relationship between serum aldosterone levels and kidney disease.

Researchers identified progression of CKD in 38% of patients, according to study conclusions. An adjusted model revealed an 11% increased risk of CKD progression for each doubling of serum aldosterone. People in the highest quartile of serum aldosterone had a 45% increased risk of developing CKD compared to those in the lowest quartile.

“These findings are important because they suggest that higher aldosterone levels may play a role in CKD progression and cardiovascular disease in CKD patients,” said Verma in a press release. “This study provides evidence for a mechanism by which mineralocorticoid receptor antagonists slow the progression of CKD and supports investigation of their value in patients without diabetes.”

In the accompanying editorial, George L. Buckris, MD Professor of Medicine and Director of the American Heart Association-certified Comprehensive Hypertension Center at the University of Chicago School of Medicine, Frederick JacerMD, PhD, A research director at the French National Institute of Hygiene and Medicine delved into the study.

“Given the time range and number of people evaluated, this important study contributes further to our knowledge base. However, plasma aldosterone is sufficient to measure levels of this hormone, whereas axis activation 24-hour urinary aldosterone corrected for creatinine is a more accurate method of determining aldosterone levels because of the increased platelet adhesion of aldosterone. They say, “We now have and need to use agents that are relatively safer and better tolerated than conventional steroids. cardiorenal risk in these patient groups. ”

References:

Aldosterone excess and cardiorenal risks: more common than evaluated. https://www.eurekalert.org/news-releases/960914? Published: August 8, 2022. Accessed: August 8, 2022.

Aldosterone is associated with progression of chronic kidney disease and an increased risk of end-stage renal disease. https://dx.doi.org/10.1093/eurheartj/ehac410Published: August 8, 2022. Accessed: August 8, 2022.

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2/ https://www.healio.com/news/nephrology/20220809/aldosterone-correlates-with-increased-risk-of-ckd-progression-eskd

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