Aldosterone, from (patho)physiology to treatment in cardiovascular and renal damage

Current Vascular Pharmacology

Volumn 9, Issue 5, 2011, Pages 594-605

  Waanders, Femke ^a   de Vries, Laura V ^a   van Goor, Harry ^a   Hillebrands, Jan Luuk ^a   Laverman, Gozewijn D ^a   Bakker, Stephan J L ^a   Navis, Gerjan ^a  

^a UNIVERSITY MEDICAL CENTER GRONINGEN   (Netherlands)

Author keywords

Aldosterone; Chronic kidney disease; Heart failure; Hypertension; Proteinuria; Spironolactone

Indexed keywords

ALDOSTERONE; ENALAPRIL; EPLERENONE; HYDROCHLOROTHIAZIDE; LOSARTAN; MINERALOCORTICOID RECEPTOR; SODIUM; SPIRONOLACTONE;

ARTICLE; CARDIOVASCULAR DISEASE; CHRONIC KIDNEY DISEASE; CLINICAL TRIAL; DRUG EFFECT; DRUG MECHANISM; DRUG SAFETY; FIBROSIS; FLUID RETENTION; HEART FAILURE; HEART MUSCLE FIBROSIS; HORMONE ACTION; HUMAN; HYPERKALEMIA; HYPERTENSION; KIDNEY INJURY; NEPHROTIC SYNDROME; NONHUMAN; PATHOPHYSIOLOGY; PRIMARY HYPERALDOSTERONISM; PROTEINURIA; RECEPTOR BLOCKING; RECEPTOR INTRINSIC ACTIVITY; RENIN ANGIOTENSIN ALDOSTERONE SYSTEM; SODIUM RESTRICTION; TREATMENT OUTCOME; VASCULAR DISEASE;

ALDOSTERONE; ANGIOTENSIN-CONVERTING ENZYME INHIBITORS; CARDIOVASCULAR DISEASES; HOMEOSTASIS; HUMANS; KIDNEY FAILURE, CHRONIC; POTASSIUM; RECEPTORS, MINERALOCORTICOID; RENIN-ANGIOTENSIN SYSTEM; SODIUM; WATER;

EID: 80051708280     PISSN: 15701611     EISSN: 18756212     Source Type: Journal    
DOI: 10.2174/157016111796642689     Document Type: Article

References (124)

1. Schrier RW. Aldosterone 'escape' vs. 'breakthrough'. Nat Rev Nephrol 2010; 6: 61.
2. Athyros VG, Mikhailidis DP, Kakafika AI, Tziomalos K, Karagiannis A. Angiotensin II reactivation and aldosterone escape phenomena in renin-angiotensin-aldosterone system blockade: is oral renin inhibition the solution? Expert Opin Pharmacother 2007; 8: 529-535.
3. Navis G, de Jong PE, Donker AJ, van der Hem GK, de ZD. Moderate sodium restriction in hypertensive subjects: renal effects of ACE-inhibition. Kidney Int 1987; 31: 815-819.
4. Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med 1999; 341: 709-717.
5. Pitt B, Remme W, Zannad F, et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 2003; 348: 1309-1321.
6. Silvestre JS, Robert V, Heymes C, et al. Myocardial production of aldosterone and corticosterone in the rat. Physiological regulation. J Biol Chem 1998; 273: 4883-4891.
7. Takeda Y. Role of cardiovascular aldosterone in hypertension. Curr Med Chem Cardiovasc Hematol Agents 2005; 3: 261-266.
8. Marney AM, Brown NJ. Aldosterone and end-organ damage. Clin Sci (Lond) 2007; 113: 267-278.
9. Arriza JL, Weinberger C, Cerelli G, et al. Cloning of human mineralocorticoid receptor complementary DNA: structural and functional kinship with the glucocorticoid receptor. Science 1987; 237: 268-275.
10. Anagnostis P, Karagiannis A, Tziomalos K, et al. Endocrine hypertension: diagnosis and management of a complex clinical entity. Curr Vasc Pharmacol 2010; 8: 646-660.
11. Bocchi B, Kenouch S, Lamarre-Cliche M, et al. Impaired 11-beta hydroxysteroid dehydrogenase type 2 activity in sweat gland ducts in human essential hypertension. Hypertension 2004; 43: 803-808.
12. Ostreicher I, Almeida JR, Campean V, et al. Changes in 11{beta}- hydroxysteroid dehydrogenase type 2 expression in a low-protein rat model of intrauterine growth restriction. Nephrol Dial Transplant 2010; 25: 3195-3203.
13. Stowasser M. Update in primary aldosteronism. J Clin Endocrinol Metab 2009; 94: 3623-3630.
14. Rossi GP, Bernini G, Desideri G, et al. Renal damage in primary aldosteronism: results of the PAPY Study. Hypertension 2006; 48: 232-238.
15. Brilla CG, Weber KT. Mineralocorticoid excess, dietary sodium, and myocardial fibrosis. J Lab Clin Med 1992; 120: 893-901.
16. Funder JW. Minireview: Aldosterone and mineralocorticoid receptors: past, present, and future. Endocrinology 2010; 151: 5098-5102.
17. Giacchetti G, Ronconi V, Turchi F, et al. Aldosterone as a key mediator of the cardiometabolic syndrome in primary aldosteronism: an observational study. J Hypertens 2007; 25: 177-186.
18. Young WF. Primary aldosteronism: renaissance of a syndrome. Clin Endocrinol (Oxf) 2007; 66: 607-618.
19. Karagiannis A, Tziomalos K, Kakafika AI, et al. Medical treatment as an alternative to adrenalectomy in patients with aldosteroneproducing adenomas. Endocr Relat Cancer 2008; 15: 693-700.
20. Aldigier JC, Kanjanbuch T, Ma LJ, Brown NJ, Fogo AB. Regression of existing glomerulosclerosis by inhibition of aldosterone. J Am Soc Nephrol 2005; 16: 3306-3314.
21. Bianchi S, Bigazzi R, Campese VM. Long-term effects of spironolactone on proteinuria and kidney function in patients with chronic kidney disease. Kidney Int 2006; 70: 2116-2123.
22. Chrysostomou A, Becker G. Spironolactone in addition to ACE inhibition to reduce proteinuria in patients with chronic renal disease. N Engl J Med 2001; 345: 925-926.
23. Miyata K, Rahman M, Shokoji T, et al. Aldosterone stimulates reactive oxygen species production through activation of NADPH oxidase in rat mesangial cells. J Am Soc Nephrol 2005; 16: 2906-2912.
24. Fiebeler A, Muller DN, Shagdarsuren E, Luft FC. Aldosterone, mineralocorticoid receptors, and vascular inflammation. Curr Opin Nephrol Hypertens 2007; 16: 134-142.
25. Funder JW. Aldosterone, salt and cardiac fibrosis. Clin Exp Hypertens 1997; 19: 885-899.
26. Rocha R, Chander PN, Zuckerman A, Stier CT, Jr. Role of aldosterone in renal vascular injury in stroke-prone hypertensive rats. Hypertension 1999; 33: 232-237.
27. Oberleithner H, Riethmuller C, Ludwig T, Hausberg M, Schillers H. Aldosterone remodels human endothelium. Acta Physiol (Oxf) 2006; 187: 305-312.
28. del Vecchio L, Procaccio M, Vigano S, Cusi D. Mechanisms of disease: The role of aldosterone in kidney damage and clinical benefits of its blockade. Nat Clin Pract Nephrol 2007; 3: 42-49.
29. Shibata S, Nagase M, Yoshida S, Kawachi H, Fujita T. Podocyte as the target for aldosterone: roles of oxidative stress and Sgk1. Hypertension 2007; 49: 355-364.
30. Nagai Y, Miyata K, Sun GP, et al. Aldosterone stimulates collagen gene expression and synthesis via activation of ERK1/2 in rat renal fibroblasts. Hypertension 2005; 46: 1039-1045.
31. van LN, Caprio M, Blaya C, et al. The functional c.-2G>C variant of the mineralocorticoid receptor modulates blood pressure, renin, and aldosterone levels. Hypertension 2010;
32. Briet M, Schiffrin EL. Aldosterone: effects on the kidney and cardiovascular system. Nat Rev Nephrol 2010; 6: 261-273.
33. Conn JW. Hypertension, the potassium ion and impaired carbohydrate tolerance. N Engl J Med 1965; 273: 1135-1143.
34. Bochud M, Nussberger J, Bovet P, et al. Plasma aldosterone is independently associated with the metabolic syndrome. Hypertension 2006; 48: 239-245.
35. Fallo F, Della MP, Sonino N, et al. Adiponectin and insulin sensitivity in primary aldosteronism. Am J Hypertens 2007; 20: 855-861.
36. Giacchetti G, Ronconi V, Turchi F, et al. Aldosterone as a key mediator of the cardiometabolic syndrome in primary aldosteronism: an observational study. J Hypertens 2007; 25: 177-186.
37. Catena C, Lapenna R, Baroselli S, et al. Insulin sensitivity in patients with primary aldosteronism: a follow-up study. J Clin Endocrinol Metab 2006; 91: 3457-3463.
38. Caprio M, Feve B, Claes A, et al. Pivotal role of the mineralocorticoid receptor in corticosteroid-induced adipogenesis. FASEB J 2007; 21: 2185-2194.
39. Rondinone CM, Rodbard D, Baker ME. Aldosterone stimulated differentiation of mouse 3T3-L1 cells into adipocytes. Endocrinology 1993; 132: 2421-2426.
40. Guo C, Ricchiuti V, Lian BQ, et al. Mineralocorticoid receptor blockade reverses obesity-related changes in expression of adiponectin, peroxisome proliferator-activated receptor-gamma, and proinflammatory adipokines. Circulation 2008; 117: 2253-2261.
41. Lastra G, Whaley-Connell A, Manrique C, et al. Low-dose spironolactone reduces reactive oxygen species generation and improves insulin-stimulated glucose transport in skeletal muscle in the TG(mRen2)27 rat. Am J Physiol Endocrinol Metab 2008; 295: E110-E116.
42. Mosso LM, Carvajal CA, Maiz A, et al. A possible association between primary aldosteronism and a lower beta-cell function. J Hypertens 2007; 25: 2125-2130.
43. Yamashita R, Kikuchi T, Mori Y, et al. Aldosterone stimulates gene expression of hepatic gluconeogenic enzymes through the glucocorticoid receptor in a manner independent of the protein kinase B cascade. Endocr J 2004; 51: 243-251.
44. Ehrhart-Bornstein M, Lamounier-Zepter V, Schraven A, et al. Human adipocytes secrete mineralocorticoid-releasing factors. Proc Natl Acad Sci USA 2003; 100: 14211-14216.
45. Ehrhart-Bornstein M, Arakelyan K, Krug AW, Scherbaum WA, Bornstein SR. Fat cells may be the obesity-hypertension link: human adipogenic factors stimulate aldosterone secretion from adrenocortical cells. Endocr Res 2004; 30: 865-870.
46. Fujita T. Mineralocorticoid receptors, salt-sensitive hypertension, and metabolic syndrome. Hypertension 2010; 55: 813-818.
47. Goodfriend TL, Ball DL, Egan BM, Campbell WB, Nithipatikom K. Epoxy-keto derivative of linoleic acid stimulates aldosterone secretion. Hypertension 2004; 43: 358-363.
48. Jeon JH, Kim KY, Kim JH, et al. A novel adipokine CTRP1 stimulates aldosterone production. FASEB J 2008; 22: 1502-1511.
49. Sowers JR, Whaley-Connell A, Epstein M. Narrative review: the emerging clinical implications of the role of aldosterone in the metabolic syndrome and resistant hypertension. Ann Intern Med 2009; 150: 776-783.
50. Wang Q, Clement S, Gabbiani G, et al. Chronic hyperaldosteronism in a transgenic mouse model fails to induce cardiac remodeling and fibrosis under a normal-salt diet. Am J Physiol Renal Physiol 2004; 286: F1178-F1184.
51. Endemann DH, Touyz RM, Iglarz M, Savoia C, Schiffrin EL. Eplerenone prevents salt-induced vascular remodeling and cardiac fibrosis in stroke-prone spontaneously hypertensive rats. Hypertension 2004; 43: 1252-1257.
52. Blasi ER, Rocha R, Rudolph AE, et al. Aldosterone/salt induces renal inflammation and fibrosis in hypertensive rats. Kidney Int 2003; 63: 1791-800.
53. Hartner A, Porst M, Gauer S, et al. Glomerular osteopontin expression and macrophage infiltration in glomerulosclerosis of DOCAsalt rats. Am J Kidney Dis 2001; 38: 153-164.
54. Nowaczynski W, Oliver WJ, Neel JV. Serum aldosterone and protein- binding variables in Yanomama Indians: a no-salt culture as compared to partially acculturated Guaymi Indians. Clin Physiol Biochem 1985; 3: 289-306.
55. Calo LA, Puato M, Schiavo S, et al. Absence of vascular remodeling in a high angiotensin-II state (Bartter's and Gitelman's syndromes): implications for angiotensin II signalling pathways. Nephrol Dial Transplant 2008; 23: 2804-2809.
56. Pimenta E, Gaddam KK, Pratt-Ubunama MN, et al. Relation of dietary salt and aldosterone to urinary protein excretion in subjects with resistant hypertension. Hypertension 2008; 51: 339-344.
57. Bibbins-Domingo K, Chertow GM, Coxson PG, et al. Projected effect of dietary salt reductions on future cardiovascular disease. N Engl J Med 2010; 362: 590-599.
58. Krikken JA, Laverman GD, Navis G. Benefits of dietary sodium restriction in the management of chronic kidney disease. Curr Opin Nephrol Hypertens 2009; 18: 531-538.
59. Takeda Y, Yoneda T, Demura M, et al. Effects of high sodium intake on cardiovascular aldosterone synthesis in stroke-prone spontaneously hypertensive rats. J Hypertens 2001; 19: 635-639.
60. Takeda Y, Yoneda T, Demura M, Miyamori I, Mabuchi H. Sodium- induced cardiac aldosterone synthesis causes cardiac hypertrophy. Endocrinology 2000; 141: 1901-1904.
61. Epstein M. Aging and the kidney. J Am Soc Nephrol 1996; 7: 1106-1122.
62. Krug AW, Allenhofer L, Monticone R, et al. Elevated mineralocorticoid receptor activity in aged rat vascular smooth muscle cells promotes a proinflammatory phenotype via extracellular signalregulated kinase 1/2 mitogen-activated protein kinase and epidermal growth factor receptor-dependent pathways. Hypertension 2010; 55: 1476-1483.
63. Schlaich MP, Schobel HP, Hilgers K, Schmieder RE. Impact of aldosterone on left ventricular structure and function in young normotensive and mildly hypertensive subjects. Am J Cardiol 2000; 85: 1199-1206.
64. Nagase M, Matsui H, Shibata S, Gotoda T, Fujita T. Salt-induced nephropathy in obese spontaneously hypertensive rats via paradoxical activation of the mineralocorticoid receptor: role of oxidative stress. Hypertension 2007; 50: 877-883.
65. van der Kleij FG, de Jong PE, Henning RH, de Zeeuw D, Navis G. Enhanced responses of blood pressure, renal function, and aldosterone to angiotensin I in the DD genotype are blunted by low sodium intake. J Am Soc Nephrol 2002; 13: 1025-1033.
66. Lely TA, Lambers Heerspink HJ, Zuurman M, et al. Response to angiotensin-converting enzyme inhibition is selectively blunted by high sodium in angiotensin-converting enzyme DD genotype: evidence for gene-environment interaction in healthy volunteers. J Hypertens 2010; 28: 2414-2421.
67. van der Kleij FG, Schmidt A, Navis GJ, et al. Angiotensin converting enzyme insertion/deletion polymorphism and short-term renal response to ACE inhibition: role of sodium status. Kidney Int Suppl 1997; 63: S23-S26.
68. Cicoira M, Zanolla L, Rossi A, et al. Failure of aldosterone suppression despite angiotensin-converting enzyme (ACE) inhibitor administration in chronic heart failure is associated with ACE DD genotype. J Am Coll Cardiol 2001; 37: 1808-1812.
69. Savoia C, Touyz RM, Amiri F, Schiffrin EL. Selective mineralocorticoid receptor blocker eplerenone reduces resistance artery stiffness in hypertensive patients. Hypertension 2008; 51: 432-439.
70. Gross E, Rothstein M, Dombek S, Juknis HI. Effect of spironolactone on blood pressure and the renin-angiotensin-aldosterone system in oligo-anuric hemodialysis patients. Am J Kidney Dis 2005; 46: 94-101.
71. Wakabayashi K, Suzuki H, Sato T, et al. Eplerenone suppresses neointimal formation after coronary stent implantation in swine. Int J Cardiol 2006; 107: 260-266.
72. Ward MR, Kanellakis P, Ramsey D, Funder J, Bobik A. Eplerenone suppresses constrictive remodeling and collagen accumulation after angioplasty in porcine coronary arteries. Circulation 2001; 104: 467-472.
73. Garnier A, Bendall JK, Fuchs S, et al. Cardiac specific increase in aldosterone production induces coronary dysfunction in aldosterone synthase-transgenic mice. Circulation 2004; 110: 1819-1825.
74. Rocha R, Stier CT, Jr., Kifor I, et al. Aldosterone: a mediator of myocardial necrosis and renal arteriopathy. Endocrinology 2000; 141: 3871-3878.
75. Waanders F, Rienstra H, Boer MW, et al. Spironolactone ameliorates transplant vasculopathy in renal chronic transplant dysfunction in rats. Am J Physiol Renal Physiol 2009; 296: F1072-F1079.
76. Rienstra H, Boersema M, Onuta G, et al. Donor and recipient origin of mesenchymal and endothelial cells in chronic renal allograft remodeling. Am J Transplant 2009; 9: 463-472.
77. Ross R, Glomset J, Harker L. Response to injury and atherogenesis. Am J Pathol 1977; 86: 675-684.
78. Farquharson CA, Struthers AD. Aldosterone induces acute endothelial dysfunction in vivo in humans: evidence for an aldosteroneinduced vasculopathy. Clin Sci (Lond) 2002; 103: 425-431.
79. Oberleithner H. Aldosterone makes human endothelium stiff and vulnerable. Kidney Int 2005; 67: 1680-1682.
80. Farquharson CA, Struthers AD. Spironolactone increases nitricoxide bioactivity, improves endothelial vasodilator dysfunction, and suppresses vascular angiotensin I/angiotensin II conversion in patients with chronic heart failure. Circulation 2000; 101: 594-597.
81. Macdonald JE, Kennedy N, Struthers AD. Effects of spironolactone on endothelial function, vascular angiotensin converting enzyme activity, and other prognostic markers in patients with mild heart failure already taking optimal treatment. Heart 2004; 90: 765-770.
82. Duprez DA, Bauwens FR, De Buyzere ML, et al. Influence of arterial blood pressure and aldosterone on left ventricular hypertrophy in moderate essential hypertension. Am J Cardiol 1993; 71: 17A-20A.
83. Duprez DA, De Buyzere ML, Rietzschel ER, et al. Inverse relationship between aldosterone and large artery compliance in chronically treated heart failure patients. Eur Heart J 1998; 19: 1371-1376.
84. Edwards NC, Steeds RP, Stewart PM, Ferro CJ, Townend JN. Effect of spironolactone on left ventricular mass and aortic stiffness in early-stage chronic kidney disease: a randomized controlled trial. J Am Coll Cardiol 2009; 54: 505-512.
85. Rocha R, Rudolph AE, Frierdich GE, et al. Aldosterone induces a vascular inflammatory phenotype in the rat heart. Am J Physiol Heart Circ Physiol 2002; 283: H1802-H1810.
86. Silvestre JS, Heymes C, Oubenaissa A, et al. Activation of cardiac aldosterone production in rat myocardial infarction: effect of angiotensin II receptor blockade and role in cardiac fibrosis. Circulation 1999; 99: 2694-2701.
87. Cameron A, Schwartz MJ, Kronmal RA, Kosinski AS. Prevalence and significance of atrial fibrillation in coronary artery disease (CASS Registry). Am J Cardiol 1988; 61: 714-717.
88. Vasan RS, Evans JC, Larson MG, et al. Serum aldosterone and the incidence of hypertension in non-hypertensive persons. N Engl J Med 2004; 351: 33-41.
89. Young M, Funder JW. Eplerenone, but not steroid withdrawal, reverses cardiac fibrosis in deoxycorticosterone/salt-treated rats. Endocrinology 2004; 145: 3153-3157.
90. Yoshimura M, Nakamura S, Ito T, et al. Expression of aldosterone synthase gene in failing human heart: quantitative analysis using modified real-time polymerase chain reaction. J Clin Endocrinol Metab 2002; 87: 3936-3940.
91. Tsybouleva N, Zhang L, Chen S, et al. Aldosterone, through novel signaling proteins, is a fundamental molecular bridge between the genetic defect and the cardiac phenotype of hypertrophic cardiomyopathy. Circulation 2004; 109: 1284-1291.
92. Rickard AJ, Morgan J, Tesch G, et al. Deletion of mineralocorticoid receptors from macrophages protects against deoxycorticosterone/salt-induced cardiac fibrosis and increased blood pressure. Hypertension 2009; 54: 537-543.
93. Iraqi W, Rossignol P, Angioi M, et al. Extracellular cardiac matrix biomarkers in patients with acute myocardial infarction complicated by left ventricular dysfunction and heart failure: insights from the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS) study. Circulation 2009; 119: 2471-2479.
94. Gerritsen J, Dekker JM, TenVoorde BJ, et al. Impaired autonomic function is associated with increased mortality, especially in subjects with diabetes, hypertension, or a history of cardiovascular disease: the Hoorn Study. Diabetes Care 2001; 24: 1793-1798.
95. MacFadyen RJ, Barr CS, Struthers AD. Aldosterone blockade reduces vascular collagen turnover, improves heart rate variability and reduces early morning rise in heart rate in heart failure patients. Cardiovasc Res 1997; 35: 30-34.
96. Struthers AD. Two new culprits in cardiovascular disease: QT dispersion and aldosterone. J Hum Hypertens 1995; 9: 659-661.
97. Greene EL, Kren S, Hostetter TH. Role of aldosterone in the remnant kidney model in the rat. J Clin Invest 1996; 98: 1063-1068.
98. van den Hoven MJ, Waanders F, Rops AL, et al. Regulation of glomerular heparanase expression by aldosterone, angiotensin II and reactive oxygen species. Nephrol Dial Transplant 2009; 24: 2637-2645.
99. Kramer AB, van der Meulen EF, Hamming I, van GH, Navis G. Effect of combining ACE inhibition with aldosterone blockade on proteinuria and renal damage in experimental nephrosis. Kidney Int 2007; 71: 417-424.
100. Rocha R, Chander PN, Khanna K, Zuckerman A, Stier CT, Jr. Mineralocorticoid blockade reduces vascular injury in stroke-prone hypertensive rats. Hypertension 1998; 31: 451-458.
101. Hamming I, Navis G, Kocks MJ, van Goor H. ACE inhibition has adverse renal effects during dietary sodium restriction in proteinuric and healthy rats. J Pathol 2006; 209: 129-139.
102. Heeg JE, de Jong PE, van der Hem GK, de Zeeuw D. Efficacy and variability of the antiproteinuric effect of ACE inhibition by lisinopril. Kidney Int 1989; 36: 272-279.
103. Vogt L, Waanders F, Boomsma F, de ZD, Navis G. Effects ofDietary Sodium and Hydrochlorothiazide on the Antiproteinuric Efficacy of Losartan. J Am Soc Nephrol 2008; 19: 999-1007.
104. Arima S, Kohagura K, Xu HL, et al. Non-genomic vascular action of aldosterone in the glomerular microcirculation. J Am Soc Nephrol 2003; 14: 2255-2263.
105. Uhrenholt TR, Schjerning J, Hansen PB, et al. Rapid inhibition of vasoconstriction in renal afferent arterioles by aldosterone. Circ Res 2003; 93: 1258-1266.
106. Arima S, Kohagura K, Xu HL, et al. Endothelium-derived nitric oxide modulates vascular action of aldosterone in renal arteriole. Hypertension 2004; 43: 352-357.
107. Epstein M, Williams GH, Weinberger M, et al. Selective aldosterone blockade with eplerenone reduces albuminuria in patients with type 2 diabetes. Clin J Am Soc Nephrol 2006; 1: 940-951.
108. Schjoedt KJ, Jacobsen P, Rossing K, Boomsma F, Parving HH. Dual blockade of the renin-angiotensin-aldosterone system in diabetic nephropathy: the role of aldosterone. Horm Metab Res 2005; 37 (Suppl) 1: 4-8.
109. McFarlane SI, Sowers JR. Cardiovascular endocrinology 1: aldosterone function in diabetes mellitus: effects on cardiovascular and renal disease. J Clin Endocrinol Metab 2003; 88: 516-523.
110. Sato A, Hayashi K, Naruse M, Saruta T. Effectiveness of aldosterone blockade in patients with diabetic nephropathy. Hypertension 2003; 41: 64-68.
111. Sato A, Saruta T. Aldosterone breakthrough during angiotensinconverting enzyme inhibitor therapy. Am J Hypertens 2003; 16: 781-788.
112. Bianchi S, Bigazzi R, Campese VM. Antagonists of aldosterone and proteinuria in patients with CKD: an uncontrolled pilot study. Am J Kidney Dis 2005; 46: 45-51.
113. Chrysostomou A, Pedagogos E, MacGregor L, Becker GJ. Doubleblind, placebo-controlled study on the effect of the aldosterone receptor antagonist spironolactone in patients who have persistent proteinuria and are on long-term angiotensin-converting enzyme inhibitor therapy, with or without an angiotensin II receptor blocker. Clin J Am Soc Nephrol 2006; 1: 256-262.
114. van den Meiracker AH, Baggen RG, Pauli S, et al. Spironolactone in type 2 diabetic nephropathy: Effects on proteinuria, blood pressure and renal function. J Hypertens 2006; 24: 2285-2292.
115. Cook NR, Cutler JA, Obarzanek E, et al. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). BMJ 2007; 334: 885.
116. Bomback AS, Kshirsagar AV, Amamoo MA, Klemmer PJ. Change in proteinuria after adding aldosterone blockers to ACE inhibitors or angiotensin receptor blockers in CKD: a systematic review. Am J Kidney Dis 2008; 51: 199-211.
117. Lakkis J, Lu WX, Weir MR. RAAS escape: a real clinical entity that may be important in the progression of cardiovascular and renal disease. Curr Hypertens Rep 2003; 5: 408-417.
118. Navis G, de Jong P, Donker AJ, van der Hem GK, de Zeeuw D. Diuretic effects of angiotensin-converting enzyme inhibition: comparison of low and liberal sodium diet in hypertensive patients. J Cardiovasc Pharmacol 1987; 9: 743-748.
119. Hollenberg NK, Chenitz WR, Adams DF, Williams GH. Reciprocal influence of salt intake on adrenal glomerulosa and renal vascular responses to angiotensin II in normal man. J Clin Invest 1974; 54: 34-42.
120. Sica DA. Pharmacokinetics and pharmacodynamics of mineralocorticoid blocking agents and their effects on potassium homeostasis. Heart Fail Rev 2005; 10: 23-29.
121. Effectiveness of spironolactone added to an angiotensin-converting enzyme inhibitor and a loop diuretic for severe chronic congestive heart failure (The Randomized Aldactone Evaluation Study [RALES]). Am J Cardiol 1996; 78: 902-907.
122. Pitt B, Bakris G, Ruilope LM, DiCarlo L, Mukherjee R. Serum potassium and clinical outcomes in the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS). Circulation 2008; 118: 1643-1650.
123. Antman EM, Hand M, Armstrong PW, et al. 2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: developed in collaboration With the Canadian Cardiovascular Society endorsed by the American Academy of Family Physicians: 2007 Writing Group to Review New Evidence and Update the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction, Writing on Behalf of the 2004 Writing Committee. Circulation 2008; 117: 296-329.
124. Swedberg K, Cleland J, Dargie H, et al. Guidelines for the diagnosisand treatment of chronic heart failure: executive summary (update 2005): The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Eur Heart J 2005; 26: 1115-1140.