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Role of Aldosterone in Renal Fibrosis

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Book cover Renal Fibrosis: Mechanisms and Therapies

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1165))

Abstract

Aldosterone is a mineralocorticoid hormone, as its main renal effect has been considered as electrolyte and water homeostasis in the distal tubule, thus maintaining blood pressure and extracellular fluid homeostasis through the activation of mineralocorticoid receptor (MR) in epithelial cells. However, over the past decade, numerous studies have documented the significant role of aldosterone in the progression of chronic kidney disease (CKD) which has become a subject of interest. It is being studied that aldosterone can affect cardiovascular and renal system, thereby contributing to tissue inflammation, injury, glomerulosclerosis, and interstitial fibrosis. Aldosterone acts on renal vessels, renal cells (glomerular mesangial cells, podocytes, vascular smooth muscle cells, tubular epithelial cells, and interstitial fibroblasts), and infiltrating inflammatory cells, inducing reactive oxygen species (ROS) production, upregulated epithelial growth factor receptor (EGFR), and type 1 angiotensin (AT1) receptor expressions, and activating nuclear factor kappa B (NF-κB), activator protein-1 (AP-1), and EGFR to further promote cell proliferation, apoptosis, and proliferation. Phenotypic transformation of epithelial cells stimulates the expression of transforming growth factor-β (TGF-β), connective tissue growth factor (CTGF), osteopontin (OPN), and plasminogen activator inhibitor-1 (PAI-1), eventually leading to renal fibrosis. MR antagonisms are related to inhibition of aldosterone-mediated pro-inflammatory and pro-fibrotic effect. In this review, we will summarize the important role of aldosterone in the pathogenesis of renal injury and fibrosis, emphasizing on its multiple underlying mechanisms and advances in aldosterone research along with the potential therapeutics for targeting MR in a renal fibrosis.

Aanchal Shrestha and Ruo-Chen Che contributed equally to this work.

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Acknowledgement and Conflict of Interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Nephrology, Children’s Hospital of Nanjing Medical University, Nanjing, China

    Aanchal Shrestha, Ruo-Chen Che & Ai-Hua Zhang

Authors
  1. Aanchal Shrestha
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  2. Ruo-Chen Che
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  3. Ai-Hua Zhang
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Correspondence to Ai-Hua Zhang .

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Editors and Affiliations

  1. Zhongda Hospital, Southeast University School of Medicine, Southeast University, Nanjing, Jiangsu, China

    Bi-Cheng Liu

  2. Department of Medicine and Therapeutics, Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong, Hong Kong

    Hui-Yao Lan

  3. Zhongda Hospital, Southeast University School of Medicine, Southeast University, Nanjing, Jiangsu, China

    Lin-Li Lv

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© 2019 Springer Nature Singapore Pte Ltd.

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Shrestha, A., Che, RC., Zhang, AH. (2019). Role of Aldosterone in Renal Fibrosis. In: Liu, BC., Lan, HY., Lv, LL. (eds) Renal Fibrosis: Mechanisms and Therapies. Advances in Experimental Medicine and Biology, vol 1165. Springer, Singapore. https://doi.org/10.1007/978-981-13-8871-2_15

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