title: A mechanism for mineralocortcoid participation in renal disease and heart failure.
abstract: Various forms of chronic renal disease as well as congestive heart failure progress irrespective of currently available supportive care. Clinical evidence indicates that blockade of the renin-angiotensin system and/or mineralocorticoid inhibition are partially effective. Recently, it was suggested that the initiation of feed-forward intracrine loops such as renin-angiotensin system up-regulation can explain the progression of disease in the face of the control of initiating factors such as high glucose or hypertension. Here, these notions are expanded to include a potential interaction of mineralocorticoid activity with intracrine renin-angiotensin system up-regulation. In addition to suggesting therapeutic interventions, these observations lead to an expanded view of intracrine physiology.
authors.affiliation: Research Division, Ochsner Clinic Foundation, New Orleans, LA, USA. Electronic address: rre@ochsner.org.
authors.forename: Richard N
authors.initials: RN
authors.lastname: Re
mesh_terms: D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy / Q000378:metabolism*; D006801:Humans; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D008901:Mineralocorticoids / Q000378:metabolism*; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy / Q000378:metabolism*; D012084:Renin-Angiotensin System / Q000187:drug effects / Q000502:physiology*
chemical_list: D057911:Angiotensin Receptor Antagonists; D000451:Mineralocorticoid Receptor Antagonists; D008901:Mineralocorticoids
keywords: Aldosterone; angiotensin; intracrine