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

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.