{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T00:19:11Z","timestamp":1792887551658,"version":"4.5.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"38","license":[{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["R01 DK115392"],"award-info":[{"award-number":["R01 DK115392"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["R01 HL153004"],"award-info":[{"award-number":["R01 HL153004"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["R01 DK16618"],"award-info":[{"award-number":["R01 DK16618"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["R01 HL155834"],"award-info":[{"award-number":["R01 HL155834"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["R25DK128858"],"award-info":[{"award-number":["R25DK128858"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["UH3DK114915"],"award-info":[{"award-number":["UH3DK114915"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["U01DK130030"],"award-info":[{"award-number":["U01DK130030"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["R25DK119751"],"award-info":[{"award-number":["R25DK119751"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Randomized controlled trials have demonstrated the efficacy of mineralocorticoid receptor (MR) antagonism in delaying chronic kidney disease (CKD) progression in diabetes; however, they have not investigated the role of aldosterone or whether these beneficial effects could be achieved in individuals without diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>The association between serum aldosterone concentrations and kidney disease progression was investigated among 3680 participants in the Chronic Renal Insufficiency Cohort. The primary outcome was CKD progression [defined as the composite of 50% decline in estimated glomerular filtration rate (eGFR) or end-stage kidney disease, whichever occurred first]. The associations between serum aldosterone and kidney disease outcomes were assessed using Cox proportional hazard models. At baseline, higher aldosterone concentrations were associated with a lower eGFR, lower serum potassium, greater urinary potassium, and protein excretion. Over a median follow-up of 9.6 years, 1412 participants developed CKD progression. In adjusted models, each doubling of serum aldosterone was associated with a 11% increased risk of CKD progression [hazard ratio (HR) 1.11, 95% confidence interval (CI) 1.04\u20131.18]. Individuals with the highest quartile of serum aldosterone had a 45% increased risk of CKD progression (HR 1.45, 95% CI 1.22\u20131.73) compared with the lowest quartile. The risk for CKD progression was similar regardless of whether patients had concomitant diabetes (P-interaction\u2009=\u20090.10).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Higher serum aldosterone levels among individuals with CKD are independently associated with an increased risk for kidney disease progression, irrespective of concomitant diabetes. These findings provide mechanistic support for MR antagonists in delaying CKD progression and suggest that they may also have a role in those without diabetes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehac352","type":"journal-article","created":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T13:49:42Z","timestamp":1665064182000},"page":"3781-3791","source":"Crossref","is-referenced-by-count":129,"title":["Aldosterone in chronic kidney disease and renal outcomes"],"prefix":"10.1093","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9497-6327","authenticated-orcid":false,"given":"Ashish","family":"Verma","sequence":"first","affiliation":[{"name":"Section of Nephrology, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Renal Section, Evans Biomedical Research Center , 650 Albany Street, X504, Boston, MA 02118 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0314-9252","authenticated-orcid":false,"given":"Anand","family":"Vaidya","sequence":"additional","affiliation":[{"name":"Center for Adrenal Disorders, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women\u2019s Hospital , Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5937-1880","authenticated-orcid":false,"given":"Sonu","family":"Subudhi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Massachusetts General Hospital , Boston, MA 02114 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4004-326X","authenticated-orcid":false,"given":"Sushrut S","family":"Waikar","sequence":"additional","affiliation":[{"name":"Section of Nephrology, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Renal Section, Evans Biomedical Research Center , 650 Albany Street, X504, Boston, MA 02118 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,8,1]]},"reference":[{"key":"2023052503003124400_ehac352-B1","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1210\/er.2018-00139","article-title":"The expanding spectrum of primary aldosteronism: implications for diagnosis, pathogenesis, and treatment","volume":"39","author":"Vaidya","year":"2018","journal-title":"Endocr Rev"},{"key":"2023052503003124400_ehac352-B2","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1001\/jama.1960.03030030014003","article-title":"Hypotensive agents and pressor substances. The effect of epinephrine, norepinephrine, angiotensin II, and others on the secretory rate of aldosterone in man","volume":"174","author":"Laragh","year":"1960","journal-title":"JAMA"},{"key":"2023052503003124400_ehac352-B3","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.kint.2019.02.030","article-title":"Mineralocorticoid receptor antagonists and kidney diseases: pathophysiological basis","volume":"96","author":"Barrera-Chimal","year":"2019","journal-title":"Kidney Int"},{"key":"2023052503003124400_ehac352-B4","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1159\/000515622","article-title":"Aldosterone and mineralocorticoid receptor signaling as determinants of cardiovascular and renal injury: from Hans Selye to the present","volume":"52","author":"Epstein","year":"2021","journal-title":"Am J 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