{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:19:41Z","timestamp":1790662781042,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Post\u2010kidney transplantation hypertension is common and is frequently driven by calcineurin inhibitor (CNI)\u2010mediated sodium retention and vasoconstriction, producing a salt\u2010sensitive phenotype in which sodium\u2010chloride cotransporter (NCC) inhibition remains the mechanistically aligned cornerstone of therapy. This opinion piece examines aldosterone synthase inhibitors (ASIs) as an emerging drug class that may have adjunctive relevance in selected resistant phenotypes after kidney transplantation. We summarize the class rationale, distinguish older less selective compounds from newer CYP11B2\u2010selective agents, and position baxdrostat within the broader ASI landscape alongside lorundrostat, vicadrostat, and earlier\u2010stage dexfadrostat data. In non\u2010transplant populations, baxdrostat and lorundrostat have lowered blood pressure in uncontrolled or resistant hypertension, whereas vicadrostat has shown cardiorenal promise in chronic kidney disease, including combination development with empagliflozin. However, no ASI has been studied in kidney transplant recipients. This gap is especially important because transplant recipients have reduced nephron reserve, frequent CNI exposure, narrow potassium margins, and a hypertensive phenotype often dominated by NCC activation rather than uniform aldosterone excess. Accordingly, ASIs should be viewed in transplantation as hypothesis\u2010generating investigational agents rather than therapeutic recommendations. Any transplant\u2010specific trial should incorporate rigorous hyperkalemia monitoring, comparator arms that reflect optimized NCC\u2010directed therapy, and formal assessment of drug\u2010drug interactions with immunosuppressants.<\/jats:p>","DOI":"10.1111\/ctr.70555","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T16:10:09Z","timestamp":1778083809000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Aldosterone Synthase Inhibition in Kidney Transplantation: Class Rationale, Translational Promise, and the Limits of Current Evidence"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7247-4950","authenticated-orcid":false,"given":"Lucas Maciel de Almeida","family":"Corr\u00eaa","sequence":"first","affiliation":[{"name":"Faculdade De Medicina De S\u00e3o Jos\u00e9 Do Rio Preto (FAMERP)  S\u00e3o Jos\u00e9 do Rio Preto 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