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Contribution of aldosterone to cardiovascular and renal inflammation and fibrosis

Open access
Brown, Nancy J.·2013·Nature Reviews Nephrology

Abstract

The steroid hormone aldosterone regulates sodium and potassium homeostasis. Aldosterone and activation of the mineralocorticoid receptor also causes inflammation and fibrosis of the heart, fibrosis and remodelling of blood vessels and tubulointerstitial fibrosis and glomerular injury in the kidney. Aldosterone and mineralocorticoid-receptor activation initiate an inflammatory response by increasing the generation of reactive oxygen species by nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and mitochondria. High salt intake potentiates these effects, in part by activating the Rho family member Rac1, a regulatory subunit of reduced NADPH oxidase that activates the mineralocorticoid receptor. Studies in mice in which the mineralocorticoid receptor has been deleted from specific cell types suggest a key role for macrophages in promoting inflammation and fibrosis. Aldosterone can exert mineralocorticoid-receptor-independent effects via the angiotensin II receptor and via G-protein-coupled receptor 30. Mineralocorticoid-receptor antagonists are associated with decreased mortality in patients with heart disease and show promise in patients with kidney injury, but can elevate serum potassium concentration. Studies in rodents genetically deficient in aldosterone synthase or treated with a pharmacological aldosterone-synthase inhibitor are providing insight into the relative contribution of aldosterone compared with the contribution of mineralocorticoid-receptor activation in inflammation, fibrosis, and injury. Aldosterone-synthase inhibitors are under development in humans.

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Metadata

Authors
Brown, N. J.
Venue
Nature Reviews Nephrology
Published
2013-06-18
Volume
9
Issue
8
Pages
459-469
ISSN
  • 1745-8323 (ISSN-L)
  • 1759-5061
  • 1759-507X
OpenAlex
W2067956701
Cited by
451
References
122
FWCI
4.00
Type
journal article
Language
en
Open access
green

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CoChat. (2026). Citation check: Contribution of aldosterone to cardiovascular and renal inflammation and fibrosis. https://app.cochat.ai/papers/10.1038/nrneph.2013.110
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Brown, N. J. (2013). Contribution of aldosterone to cardiovascular and renal inflammation and fibrosis. Nature Reviews Nephrology. https://doi.org/10.1038/nrneph.2013.110

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