Aldosterone: Implications in Diabetic Nephropathy

Abstract

Abstract: Objective: The focus of this review is to summarize the recent advancement to understand the molecular pathogenesis of diabetic nephropathy (DN). Also, to highlight the role of abnormal aldosterone secretion on the development and progression of diabetic nephropathy. Background: Diabetic Nephropathy (DN) is a progressive disease of nephron due to slow progressive failure of kidney tubule to perform its filtration process. It is often associated with proteinuria and glomerular stiffening which eventually leads to low glomerular filtration rate, finally succumbs the patient toward the end stage of kidney disease. The abnormal level of aldosterone in diabetes mellitus is a fatal combination to combat because of progressive development of diabetic nephropathy. Methods: We reviewed the literatures for implications of aldosterone in diabetic nephropathy. The literatures that were related to different aspects of diabetic nephropathy in relation to aldosterone were analyzed and summarized in this review article. Result & Conclusion: Aldosterone, a mineralocorticoid of corticosteroid hormones releases under the influence of adrenocorticotrophic hormone (ACTH) from zona glomerulosa of adrenal gland of kidney. In normal physiological condition it regulates the renin-angiotensin system of kidney, which regulates the resorption and conservation of sodium (Na+), potassium (K+) ions and water (H2O) from distal tubule. Aldosterone secretion, despite an important regulator to maintain the equilibrium of water and ions in the body, its non-regulated higher secretion gives rise to various pathological conditions. Additionally, we also discuss the risk factors associated with the use of mineralocorticoid receptor antagonist and renin-angiotensin-aldosterone therapy, and suggesting the need of robust and controlled methods to administer these drugs. Keywords: Aldosterone, Diabetic nephropathy (DN), Diabetes mellitus, Mmineralocorticoid receptor antagonists, Renin angiotensin system