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Open Access Highly Accessed Research article

Aldosterone and glomerular filtration – observations in the general population

Anke Hannemann1*, Rainer Rettig2, Kathleen Dittmann1, Henry Völzke3, Karlhans Endlich4, Matthias Nauck1 and Henri Wallaschofski1

Author Affiliations

1 Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany

2 Institute of Physiology, University Medicine Greifswald, Greifswald-Karlsburg, Germany

3 Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany

4 Institute of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Germany

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BMC Nephrology 2014, 15:44  doi:10.1186/1471-2369-15-44

Published: 10 March 2014

Abstract

Background

Increasing evidence suggests that aldosterone promotes renal damage. Since data on the association between aldosterone and renal function in the general population are sparse, we chose to address this issue. We investigated the associations between the plasma aldosterone concentration (PAC) or the aldosterone-to-renin ratio (ARR) and the estimated glomerular filtration rate (eGFR) in a sample of adult men and women from Northeast Germany.

Methods

A study population of 1921 adult men and women who participated in the first follow-up of the Study of Health in Pomerania was selected. None of the subjects used drugs that alter PAC or ARR. The eGFR was calculated according to the four-variable Modification of Diet in Renal Disease formula. Chronic kidney disease (CKD) was defined as an eGFR <60 ml/min/1.73 m2.

Results

Linear regression models, adjusted for sex, age, waist circumference, diabetes mellitus, smoking status, systolic and diastolic blood pressures, serum triglyceride concentrations and time of blood sampling revealed inverse associations of PAC or ARR with eGFR (ß-coefficient for log-transformed PAC −3.12, p < 0.001; ß-coefficient for log-transformed ARR −3.36, p < 0.001). Logistic regression models revealed increased odds for CKD with increasing PAC (odds ratio for a one standard deviation increase in PAC: 1.35, 95% confidence interval: 1.06-1.71). There was no statistically significant association between ARR and CKD.

Conclusion

Our study demonstrates that PAC and ARR are inversely associated with the glomerular filtration rate in the general population.

Keywords:
Aldosterone; Aldosteronism; Epidemiology; Glomerular Filtration; Renal function