{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T07:46:37Z","timestamp":1770277597411,"version":"3.49.0"},"reference-count":10,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T00:00:00Z","timestamp":1669766400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The renin\u2013angiotensin\u2013aldosterone system (RAAS) is a major target for treating hypertension and preventing various complications. Mineralocorticoid receptor (MR) antagonists are recommended as specific drugs to ameliorate hyperactive MR signaling, especially for patients with idiopathic hyperaldosteronism. However, the clinical implications of an increased RAAS activity and angiotensin II level induced by MR antagonist administration remain unclear. A 72-year-old Japanese man was referred to our university hospital for refractory hypertension management. He has also had type 2 diabetes mellitus and nephropathy for 8\u2005years. MR antagonists, initiated based on the diagnosis of primary aldosteronism, effectively improved his hypertension. However, proteinuria of 2.5\u2005g\/g creatinine, concomitant with an increase in both active renin concentration and plasma aldosterone concentration, occurred. Additional administration of an angiotensin II receptor blocker successfully reduced the plasma aldosterone concentration and proteinuria (&amp;lt;0.3\u2005g\/g creatinine). Preserved renal function was confirmed for 1\u2005year thereafter. In conclusion, this case suggests that the angiotensin II receptor is a potential target to treat proteinuria concomitant with primary aldosteronism. RAAS reactivation should be considered when an MR antagonist is initiated for patients with primary aldosteronism, especially idiopathic hyperaldosteronism.<\/jats:p>","DOI":"10.1210\/jcemcr\/luac021","type":"journal-article","created":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T16:09:00Z","timestamp":1669824540000},"source":"Crossref","is-referenced-by-count":2,"title":["Reduction of Proteinuria in a Patient With Primary Aldosteronism by Angiotensin II Receptor Blocker Administration"],"prefix":"10.1210","volume":"1","author":[{"given":"Junjiro","family":"Rikitake","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine , Kurume, Fukuoka 830-0011 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8753-6016","authenticated-orcid":false,"given":"Kenji","family":"Ashida","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine , Kurume, Fukuoka 830-0011 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mami","family":"Miura","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine , Kurume, Fukuoka 830-0011 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0725-3161","authenticated-orcid":false,"given":"Masatoshi","family":"Nomura","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine , Kurume, Fukuoka 830-0011 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2022,11,30]]},"reference":[{"issue":"23","key":"2023100215461632900_luac021-B1","doi-asserted-by":"crossref","first-page":"2219","DOI":"10.1056\/NEJMoa2025845","article-title":"Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes","volume":"383","author":"Bakris","year":"2020","journal-title":"N Engl J Med"},{"issue":"Suppl 99","key":"2023100215461632900_luac021-B2","doi-asserted-by":"crossref","first-page":"S57","DOI":"10.1111\/j.1523-1755.2005.09911.x","article-title":"The role of renin-angiotensin-aldosterone system in the progression of chronic kidney disease","volume":"68","author":"Remuzzi","year":"2005","journal-title":"Kidney Int"},{"issue":"2","key":"2023100215461632900_luac021-B3","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1111\/joim.12831","article-title":"Diagnosis and treatment of primary aldosteronism: practical clinical 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detection, diagnosis, and treatment: an Endocrine Society clinical practice guideline","volume":"101","author":"Funder","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2023100215461632900_luac021-B7","doi-asserted-by":"crossref","first-page":"1688","DOI":"10.1210\/jc.2011-2504","article-title":"Confirmatory testing in primary aldosteronism","volume":"97","author":"Nanba","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2023100215461632900_luac021-B8","first-page":"39","article-title":"Laboratory investigation of primary aldosteronism","volume":"31","author":"Stowasser","year":"2010","journal-title":"Clin Biochem Rev"},{"issue":"1","key":"2023100215461632900_luac021-B9","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1186\/s12882-016-0337-0","article-title":"Effect of mineralocorticoid receptor antagonists on proteinuria and progression of chronic kidney disease: a systematic review and 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