During this time CKD progression occurred in 1412 (38%) of the participants. They followed the patients for an average (median) of nearly ten years. They focused on CKD progression, which was defined as a 50% decline in the ability of the kidneys to filter blood through the glomerular blood vessels, known as the estimated glomerular filtration rate (eGFR), or end-stage kidney disease, whichever occurred first. The participants were aged between 21 and 74 years old. “Since excessive levels of aldosterone is very common, yet mostly unrecognised, we hypothesised that one reason why finerenone was effective in lowering the risk of CKD progression was that it was treating unrecognised high concentrations of the hormone,” said Dr Verma.ĭr Verma and his colleagues investigated the associations between aldosterone concentrations in the blood and kidney disease progression among 3680 participants in the Chronic Renal Insufficiency Cohort study, which ran in seven clinics in the US between 20. When this receptor is activated by aldosterone, elevated levels of the hormone lead to high blood pressure, cardiovascular and kidney diseases.

However, the role of aldosterone in this process was not directly investigated and levels of the hormone were not measured.” įinerenone targets the non-steroidal mineralocorticoid receptor (MR). The lead author of the study, Dr Ashish Verma, assistant professor at Boston University School of Medicine, USA, said: “Recent randomised controlled trials have shown that a drug called finerenone is effective in delaying CKD progression and adverse cardiovascular outcomes in patients with chronic kidney disease and diabetes. Too much of it can lead to high blood pressure, cardiovascular and kidney diseases. Its main role is to regulate salt and water in the body, and so it plays a central role in controlling blood pressure.

The findings are important because they suggest that aldosterone plays a role in the progression not only of CKD but also heart and blood vessel problems, and that an existing drug that targets the action of aldosterone may help to prevent CKD getting worse.Īldosterone is a steroid hormone secreted by the adrenal glands, which sit above the kidneys. The risk of CKD worsening and developing into end-stage kidney disease was independent of whether or not patients had diabetes. A steroid hormone called aldosterone is linked to an increased risk of kidney failure in patients with chronic kidney disease (CKD), according to a study published in the European Heart Journal today (Tuesday).

Adrenal gland and kidney function