{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T14:45:14Z","timestamp":1785941114559,"version":"3.56.0"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"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":["J of Diabetes Invest"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Residual albuminuria remains a major clinical challenge in patients with type 2 diabetes mellitus and hypertension despite renin\u2013angiotensin system inhibitor therapy. Esaxerenone, a selective nonsteroidal mineralocorticoid receptor antagonist, reduces albuminuria; however, its effects on oxidative stress remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This 24\u2010week, prospective, randomized, open\u2010label, multicenter exploratory trial was conducted in Japan. Hypertensive patients with type 2 diabetes mellitus and albuminuria receiving standard\u2010dose angiotensin II receptor blocker therapy were randomized to angiotensin II receptor blocker dose escalation or esaxerenone add\u2010on therapy. Of 50 randomized patients, 47 were included in the full analysis set and 39 in the final analysis population (20 in the angiotensin II receptor blocker dose\u2010escalation group and 19 in the esaxerenone add\u2010on group). The primary endpoints were changes from baseline to Week 24 in urinary albumin\u2010to\u2010creatinine ratio and oxidative stress assessed by diacron\u2010reactive oxygen metabolites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Esaxerenone add\u2010on therapy produced a significantly greater reduction in log\u2010transformed urinary albumin\u2010to\u2010creatinine ratio than angiotensin II receptor blocker dose\u2010escalation therapy, with an adjusted between\u2010group ratio of 0.71 (95% confidence interval, 0.58\u20130.87;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Systolic and diastolic blood pressures were significantly lower with esaxerenone. Estimated glomerular filtration rate decreased more with esaxerenone, whereas serum potassium levels did not differ significantly between groups. No significant between\u2010group difference was observed in diacron\u2010reactive oxygen metabolites.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In hypertensive patients with type 2 diabetes mellitus and albuminuria, esaxerenone add\u2010on therapy reduced albuminuria and blood pressure more effectively than angiotensin II receptor blocker dose escalation but did not significantly reduce oxidative stress.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdi.70412","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T13:45:55Z","timestamp":1785937555000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of esaxerenone add\u2010on therapy versus angiotensin\n                    <scp>II<\/scp>\n                    receptor blocker dose escalation on albuminuria and blood pressure in hypertensive patients with type 2 diabetes: An exploratory randomized study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6137-5493","authenticated-orcid":false,"given":"Makoto","family":"Ohara","sequence":"first","affiliation":[{"name":"Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine Showa Medical University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takemasa","family":"Omachi","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine Showa Medical University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuaki","family":"Takehana","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine Showa Medical University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoki","family":"Fujikawa","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine Showa Medical University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoya","family":"Osaka","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine Showa Medical University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunichiro","family":"Irie","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Tokatsu Hospital  Chiba Japan"},{"name":"Department of Internal Medicine Tokatsu Hospital Huzoku Nagareyama Central Park Ekimae Clinic  Chiba 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