Pathophysiological roles of aldosterone and mineralocorticoid receptor in the kidney

Aldosterone,a steroid hormone,has traditionally been viewed as a key regulator of fluid and electrolyte homeostasis,as well as blood pressure,through the activation of mineralocorticoid receptor (mr). however,a number of studies performed in the last decade have revealed an important role of aldosterone/mr in the pathogenesis of renal injury. aldosterone/mr-induced renal tissue injury is associated with increased renal inflammation and oxidative stress,fibrosis,mesangial cell proliferation,and podocyte injury,probably through genomic and non-genomic pathways. however,our preliminary data have indicated that acute administration of aldosterone or a selective mr antagonist,eplerenone,does not change blood pressure,heart rate,or renal blood flow. these data suggest that aldosterone/mr induces renal injury through mechanisms that are independent of acute changes in systemic and renal hemodynamics. in this review,we will briefly summarize the roles of aldosterone/mr in the pathogenesis of renal injury,focusing on the underlying mechanisms that are independent of systemic and renal hemodynamic changes. © the japanese pharmacological society.