{
  "abstract": "Aldosterone contributes to the progression of chronic kidney disease (CKD) not only through its effects on blood pressure (BP) but also by promoting inflammation and fibrosis in the kidney and cardiovascular system. Despite contemporary treatment with renin-angiotensin system inhibitors, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter 2 (SGLT2) inhibitors, residual risk persists for adverse kidney and cardiovascular outcomes. Aldosterone synthase inhibition (ASI) has emerged as a potent strategy to directly suppress aldosterone production. Several selective inhibitors, including baxdrostat, lorundrostat, and vicadrostat, have been shown to lower aldosterone levels without affecting cortisol synthesis in a clinically meaningful manner. Clinical studies in hypertension consistently show a decrease in systolic BP with these agents. In a CKD population, vicadrostat dose-dependently reduced the urinary albumin-to-creatinine ratio with additional BP lowering, and possibly greater albuminuria reduction when combined with empagliflozin. Similar findings have been observed with lorundrostat and baxdrostat in patients with CKD and uncontrolled hypertension. Median increases in serum potassium of ∼0.3 mmol/l that have been observed with ASI were generally manageable in clinical trial populations. Emerging evidence from clinical trials and meta-analyses suggests that concomitant SGLT2 inhibitor therapy may mitigate the risk of clinically significant hyperkalaemia, also supporting the use of combination therapy. Overall, ASI provide a potentially beneficial approach to reduce residual risks of CKD. Several phase 3 trials testing vicadrostat or baxdrostat across different populations with CKD, hypertension, or cardiovascular disease will determine whether favourable effects on albuminuria translate into improved kidney and cardiovascular outcomes.",
  "abstract_shown": true,
  "affiliations": [
    "Providence Medical Research Centre, Providence Inland Northwest Health, Spokane, WA, USA.",
    "Nephrology Division and Kidney Research Institute, University of Washington School of Medicine, Seattle, WA, USA.",
    "Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.",
    "Faculty of Medicine, University of Belgrade, Belgrade, Serbia.",
    "Department of Nephrology and Haemodialysis, University Hospital Centre \"Dr Dragisa Misovic\", Belgrade, Serbia.",
    "Department of Endocrinology and Metabolism, Cleveland Clinic Foundation, Cleveland, OH, USA.",
    "Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, University of Minnesota, Minneapolis, MN, USA.",
    "Toronto General Hospital, Toronto, ON, Canada.",
    "Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.",
    "Renal Studies Group, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.",
    "Oxford Kidney Unit, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.",
    "Division of Nephrology and St. Paul's Hospital/Providence Health care, University of British Columbia, Vancouver, Canada.",
    "Steno Diabetes Center, Copenhagen, Herlev, Denmark."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
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        0,
        1,
        2
      ],
      "name": "Katherine R Tuttle",
      "orcid": "0000-0002-2235-0103"
    },
    {
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        3,
        4
      ],
      "name": "Jasna B Trbojevic-Stankovic"
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    {
      "affs": [
        0,
        2
      ],
      "name": "Radica Z Alicic"
    },
    {
      "affs": [
        5,
        6
      ],
      "name": "Maria Luiza Caramori"
    },
    {
      "affs": [
        7
      ],
      "name": "David Cherney"
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    {
      "affs": [
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      ],
      "name": "Ricardo Correa Rotter"
    },
    {
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        9,
        10
      ],
      "name": "William G Herrington"
    },
    {
      "affs": [
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        10
      ],
      "name": "Parminder K Judge"
    },
    {
      "affs": [
        11
      ],
      "name": "Adeera Levin"
    },
    {
      "affs": [
        12
      ],
      "name": "Peter Rossing"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1rrpt2km265w4.bib",
  "cited_by": 0,
  "doi": "10.1093/ckj/sfag229",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13716676/?tool=EBI",
  "id": "1rrpt2km265w4",
  "issns": [
    "2048-8505",
    "2048-8513"
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  "landing_url": "https://europepmc.org/article/PMC/PMC13716676",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "AcademicSubjects/MED00340"
    ],
    [
      "heading",
      "CKJ Review"
    ],
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      "openalex",
      "2712|Hormonal Regulation and Hypertension"
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  "openalex": "W7167891478",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13716676/pdf/?tool=EBI",
  "pmcid": "PMC13716676",
  "pmid": "42959236",
  "published": "2026-07-10",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/1rrpt2km265w4.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:39Z",
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Hormonal Regulation and Hypertension",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Aldosterone synthase inhibition for treatment of people with chronic kidney disease",
  "title_text": "Aldosterone synthase inhibition for treatment of people with chronic kidney disease",
  "type": "peer-reviewed",
  "updated_at": "2026-11-02T12:21:09Z",
  "url": "https://research.draconitic.com/paper/1rrpt2km265w4",
  "venue": "Clinical kidney journal",
  "versions": []
}