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MRA Inhibition in CKD: More Than Salt and Water

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Book cover Cardio-Renal Clinical Challenges

Abstract

Chronic kidney disease (CKD) is one of the major causes of morbidity and mortality worldwide and it is closely related to cardiovascular disease. The most important causes of CKD in developed countries are diabetic nephropathy and renovascular disease/hypertension. Despite a proven favorable effect of RAAS blockade on short-term parameters (blood pressure, proteinuria) as well as long term outcome (slower decline of GFR), progression of chronic kidney disease to end stage renal disease still occurs in many patients. Mineralocorticoid receptor activation inhibition is currently being studied as a new therapeutic approach to CKD. Next to the classic anti-diuretic and potassium wasting effects, aldosterone has been shown to directly impact the heart, central nervous system, vasculature and kidneys, promoting inflammation, fibrosis and tissue remodeling, independently of its effect on sodium status and blood pressure. In this chapter we will describe the non-conventional renal and extrarenal effects of aldosterone, and review the effects of mineralocorticoid receptor antagonists in cardiovascular diseases and chronic kidney disease.

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Author information

Authors and Affiliations

  1. Department of Internal Medicine/Nephrology, ZGT Hospital, Zilvermeeuw 1, Almelo, Overijssel, 7609 PP, The Netherlands

    Christina Gant Bsc & Gozewijn Dirk Laverman MD, PhD

  2. Department of Medicine, University Medical Center Groningen, Hanzeplein 1, Groningen, 9700 RB, The Netherlands

    Gerjan Navis MD, PhD

Authors
  1. Christina Gant Bsc
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  2. Gozewijn Dirk Laverman MD, PhD
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  3. Gerjan Navis MD, PhD
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Correspondence to Christina Gant Bsc .

Editor information

Editors and Affiliations

  1. Renal and Transplantation Department, Guy's Hospital, London, United Kingdom

    David Goldsmith

  2. Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania

    Adrian Covic

  3. Karolinska Institutet Danderyd University Hospital, Stockholm, Sweden

    Jonas Spaak

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Gant, C., Laverman, G.D., Navis, G. (2015). MRA Inhibition in CKD: More Than Salt and Water. In: Goldsmith, D., Covic, A., Spaak, J. (eds) Cardio-Renal Clinical Challenges. Springer, Cham. https://doi.org/10.1007/978-3-319-09162-4_5

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  • DOI: https://doi.org/10.1007/978-3-319-09162-4_5

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