A review of current diagnostic and treatment methods for key aldosterone-related diseases

¹ Henan International Joint Laboratory of Recombinant Pharmaceutical Protein Expression System, Xinxiang Medical University, Xinxiang 453003, Henan, China

² Zhengzhou Immuno Biotech Co., Ltd., Henan, China

GPD 2022, 1(2), 136 https://doi.org/10.36922/gpd.v1i2.136

Submitted: 15 June 2022 | Accepted: 12 September 2022 | Published: 3 October 2022

© 2022 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

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Abstract

Aldosterone is a steroid hormone secreted from the adrenal cortex and metabolized primarily in the kidneys. It promotes sodium retention and potassium excretion. Most plasma aldosterone exists in free form, with a rapid turnover rate. The increased in aldosterone in the body may lead to various metabolic diseases, such as primary aldosteronism, diabetes, and chronic kidney disease. The clinical detection methods for aldosterone include radioimmunoassay, chemiluminescence immunoassay, and liquid chromatography tandem mass spectrometry (LC-MS/MS). In addition to addressing the issue of false negatives and false positives from cross-reaction in immunoassays, the advantages of high-throughput detection are reflected through the use of LC-MS/MS. Furthermore, there is also new progress in the development of a related mineralocorticoid receptor (MR) antagonist, from spironolactone to eplerenone, and to a third-generation MR antagonist, and finerenone, which has been approved by the United States Food and Drug Administration in 2021. The side effects of spironolactone and eplerenone can be overcome by finerenone, and the third-generation antagonist has shown significant effect in the treatment of chronic kidney disease associated with Type 2 diabetes. In this paper, aldosterone-related diseases, the clinical detection methods, and the corresponding treatment methods are discussed.

Keywords

Aldosterone

Primary aldosteronism

Liquid chromatography tandem mass spectrometry

Mineralocorticoid receptor antagonist

Funding

Basic Research Project of Henan Provincial Key Scientific Research Program

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Conflict of interest

The authors declare no conflict of interest.

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