Trial reportBMC nephrology2017
Renoprotective RAAS inhibition does not affect the association between worse renal function and higher plasma aldosterone levels.
Trial report in BMC nephrology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers for adults with early (stage 1 to 3) non-diabetic chronic kidney disease.The Cochrane database of systematic reviews · 2023Pooled it
- Altered dietary salt intake for people with chronic kidney disease.The Cochrane database of systematic reviews · 2021Pooled it
- Dietary Sodium Intake and Health Indicators: A Systematic Review of Published Literature between January 2015 and December 2019.Advances in nutrition (Bethesda, Md.) · 2020Pooled it
- Maternal kidney adaptation and function in pregnancy: review and perspectives.Function (Oxford, England) · 2026Review
- The Burden, Outcomes, and Management of Patients with Aldosterone Dysregulation: A Targeted Literature Review.Advances in therapy · 2026Review
- Risk of Hypertension and Chronic Kidney Disease Following Aldosterone Dysregulation.American journal of hypertension · 2026Article
- Real-world evidence of lisinopril in pediatric hypertension and nephroprotective management: a 10-year cohort study.Pediatric nephrology (Berlin, Germany) · 2025Article
- Mineralocorticoid Receptor Antagonists in Diabetic Kidney Disease: Clinical Evidence and Potential Adverse Events.Clinical diabetes : a publication of the American Diabetes Association · 2025Article
- Organoprotective Effects of Spironolactone on Top of Ramipril Therapy in a Mouse Model for Alport Syndrome.Journal of clinical medicine · 2021Article
- Escaping residual albuminuria in hypertension: should we start eplerenone or reduce salt intake?Hypertension research : official journal of the Japanese Society of Hypertension · 2019Article
- Lower Renal Function Is Associated With Derangement of 11-Journal of the Endocrine Society · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAldosterone is elevated in chronic kidney disease (CKD) and may be involved in hypertension. Surprisingly, the determinants of the plasma aldosterone concentration (PAC) and its role in hypertension are not well studied in CKD. Therefore, we studied the determinants of aldosterone and its association with blood pressure in CKD patients. We also studied this during renin-angiotensin-aldosterone system inhibition (RAASi) to establish clinical relevance, as RAASi is the treatment of choice in CKD with albuminuria.
methodsWe performed a post-hoc analysis on data from a randomized controlled double blind cross-over trial in non-diabetic CKD patients (n = 33, creatinine clearance (CrCl) 85 (75-95) ml/min, proteinuria 3.2 (2.5-4.0) g/day). Patients were treated with losartan 100 mg (ARB), and ARB + hydrochlorothiazide 25 mg (HCT), during both a regular (200 ± 10 mmol Na
resultsLower CrCl was correlated with higher PAC during placebo as well as during ARB (β = -1.213, P = 0.008 and β = -1.090, P = 0.010). Higher PAC was not explained by high renin, illustrated by a comparable association between CrCl and the aldosterone-to-renin ratio. The association between lower CrCl and higher PAC was also found in a second study with single RAASi with ACE inhibition (ACEi; lisinopril 40 mg/day), and dual RAASi (lisinopril 40 mg/day + valsartan 320 mg/day). Higher PAC was associated with a higher systolic blood pressure (P = 0.010) during different study periods. Only during maximal treatment with ARB + HCT + dietary sodium restriction, blood pressure was no longer different in subjects with a PAC above and below the median.
conclusionsIn CKD patients with a standardized regular sodium intake, worse renal function is associated with a higher aldosterone, untreated and during RAASi with either ARB, ACEi, or both. Furthermore, higher aldosterone is associated with higher blood pressure, which can be treated with the combination of RAASi, HCT and dietary sodium restriction. The first study was performed before it was standard to register trials and the study was not retrospectively registered. The second study was registered in the Netherlands Trial Register on the 5th of May 2006 (NTR675).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.