Aldosterone

Definition

Aldosterone is a hormone produced in the adrenal gland. This steroid molecule, derived from cholesterol, promotes retention of sodium and water and lowers the levels of potassium in the blood through many mechanisms, including action on the mineralocorticoid receptors in the kidneys. It plays a central role in the regulation of blood pressure.

Latest Research and Reviews

  • Research | | open

    High aldosterone levels cause heart damage independently of its well-known effect on blood pressure. Here, Cannavo et al. show that aldosterone-mediated cardiac pathology involves G protein-coupled receptor (GPCR) kinase 2 (GRK2) and GRK5 that integrate signals from angiotensin II receptor (AT1R).

    • Alessandro Cannavo
    • , Daniela Liccardo
    • , Akito Eguchi
    • , Katherine J. Elliott
    • , Christopher J. Traynham
    • , Jessica Ibetti
    • , Satoru Eguchi
    • , Dario Leosco
    • , Nicola Ferrara
    • , Giuseppe Rengo
    •  & Walter J. Koch
  • Reviews |

    Over the past 20 years, it has become clear that aldosterone exerts direct effects on the vasculature, heart and kidney beyond its effects on electrolyte handling in the distal tubule. In addition, mineralocorticoid-receptor activation has been shown to contribute to cardiovascular fibrosis and remodelling as well as to renal disease. This Review describes in detail the proinflammatory and profibrotic effects of aldosterone and mineralocorticoid-receptor activation in the heart, vasculature and kidney.

    • Nancy J. Brown
  • Research |

    Felix Beuschlein, Martin Reincke and colleagues identify recurrent somatic mutations in ATP1A1 and ATP2B3 in aldosterone-producing adenomas with wild-type KCNJ5. The ATP1A1 and ATP2B3 mutations alter conserved residues and lead to impaired sodium, potassium and calcium ion homeostasis.

    • Felix Beuschlein
    • , Sheerazed Boulkroun
    • , Andrea Osswald
    • , Thomas Wieland
    • , Hang N Nielsen
    • , Urs D Lichtenauer
    • , David Penton
    • , Vivien R Schack
    • , Laurence Amar
    • , Evelyn Fischer
    • , Anett Walther
    • , Philipp Tauber
    • , Thomas Schwarzmayr
    • , Susanne Diener
    • , Elisabeth Graf
    • , Bruno Allolio
    • , Benoit Samson-Couterie
    • , Arndt Benecke
    • , Marcus Quinkler
    • , Francesco Fallo
    • , Pierre-Francois Plouin
    • , Franco Mantero
    • , Thomas Meitinger
    • , Paolo Mulatero
    • , Xavier Jeunemaitre
    • , Richard Warth
    • , Bente Vilsen
    • , Maria-Christina Zennaro
    • , Tim M Strom
    •  & Martin Reincke
    Nature Genetics 45, 440–444
  • Research |

    The hormone aldosterone can damage the heart after myocardial infarction, such that drugs that inhibit its action are often prescribed. B. Julie He et al. now uncover a new pathway underlying the detrimental effects of aldosterone action: oxidation of the enzyme Ca2+/calmodulin-dependent protein kinase II leads to its activation and increased expression of the metalloprotease MMP9 in cardiac muscle cells, thereby promoting cardiac rupture.

    • B Julie He
    • , Mei-ling A Joiner
    • , Madhu V Singh
    • , Elizabeth D Luczak
    • , Paari Dominic Swaminathan
    • , Olha M Koval
    • , William Kutschke
    • , Chantal Allamargot
    • , Jinying Yang
    • , Xiaoqun Guan
    • , Kathy Zimmerman
    • , Isabella M Grumbach
    • , Robert M Weiss
    • , Douglas R Spitz
    • , Curt D Sigmund
    • , W Matthijs Blankesteijn
    • , Stephane Heymans
    • , Peter J Mohler
    •  & Mark E Anderson
    Nature Medicine 17, 1610–1618
  • Reviews |

    Aldosterone is a steroid hormone that is mainly recognized for its action on sodium reabsorption in the distal nephron of the kidney. In addition, however, aldosterone exerts other effects on the kidney, blood vessels and the heart, which can have pathophysiological consequences. In this Review, Briet and Schiffrin discuss the mechanisms of aldosterone-induced kidney and cardiovascular injury. The role of mineralocorticoid receptor antagonists in preventing the progression of chronic kidney disease and in the treatment of patients at high risk of cardiovascular events is also described.

    • Marie Briet
    •  & Ernesto L. Schiffrin

News and Comment