Miroslav Šašinka, Katarína Furková, Igor Riečanský, Ingrid Schusterová
Many etiopathogenetic effects which were in the past ascribe to angiotensin are really the effects of the aldosterone.
In the kidney is aldosterone binding on the mineralocorticoid receptors localized in the cell nucleus of distal and collected
tubules. Physiologically aldosterone regulates Na+ and K+ homeostasis – augments Na+ reabsorption and K+, Mg+
and H+ excretion and is basic hormone of the circulated fluids regulation, it causes tissue damage, enlarges proteinuria,
starts inflammation and accelerates chronic kidney diseases (CKD) progression. Mineralocortocoid receptors antagonists
block these effects, favorable influence vessels, reduce mortality in patients with serious forms of CKD, and its
progression, ameliorate renal hemodynamics, glomerulosclerosis and diminishe proteinuria. Effect of the combination
of aldosterone blockers with RAS blockers monotherapy has additive effect – it bypasses escape phenomena of the
ACE and aldosterone, it’s valuable in hypertension therapy, reduces drugs number in blood pressure therapy and doses
of the others antihypertensive drugs. Successful is in resistant hypertension treatment, too.