{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1361699993807112832.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.1161/01.hyp.0000044937.95080.e9"}},{"identifier":{"@type":"URI","@value":"https://www.ahajournals.org/doi/full/10.1161/01.HYP.0000044937.95080.E9"}},{"identifier":{"@type":"PMID","@value":"12511531"}},{"identifier":{"@type":"NAID","@value":"30022677269"}}],"dc:title":[{"@value":"Effectiveness of Aldosterone Blockade in Patients With Diabetic Nephropathy"}],"description":[{"type":"abstract","notation":[{"@value":"<jats:p>It has been reported that continuous ACE inhibitor therapy does not necessarily produce a maintained decrease in plasma aldosterone levels, which may remain high or increase eventually during long-term use (aldosterone escape). We have examined the role of aldosterone escape in 45 patients with type 2 diabetes and early nephropathy treated with an ACE inhibitor for 40 weeks. With treatment, there was a 40% reduction in average urinary albumin excretion, although urinary albumin excretion in patients with aldosterone escape (18 patients) was significantly higher than that in patients without escape (27 patients). In the 18 patients with escape, spironolactone (25 mg/d) was added to ACE inhibitor treatment in 13. After a 24-week study period, urinary albumin excretion and left ventricular mass index were significantly reduced without blood pressure change. In conclusion, the present study demonstrates that aldosterone escape is observed in 40% of patients with type 2 diabetes with early nephropathy despite the use of ACE inhibitors. Our study suggests the possibility that aldosterone blockade may represent optimal therapy for patients with early diabetic nephropathy who show aldosterone escape during ACE inhibitor treatment and who no longer show maximal antiproteinuric effects of ACE inhibition. Additional, larger, prospectively randomized, double-blind studies will be needed before adaptation of this strategy.</jats:p>"}]}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1381699993807112835","@type":"Researcher","foaf:name":[{"@value":"Atsuhisa Sato"}],"jpcoar:affiliationName":[{"@value":"From the Department of Internal Medicine, Mito Red Cross Hospital (A.S.), Ibaraki; the Department of Internal Medicine, Keio University (K.H., T.S.), Tokyo; and the Department of Medicine, Institute of Clinical Endocrinology, Tokyo Women’s Medical University (M.N.), Tokyo, Japan."}]},{"@id":"https://cir.nii.ac.jp/crid/1381699993807112834","@type":"Researcher","foaf:name":[{"@value":"Koichi Hayashi"}],"jpcoar:affiliationName":[{"@value":"From the Department of Internal Medicine, Mito Red Cross Hospital (A.S.), Ibaraki; the Department of Internal Medicine, Keio University (K.H., T.S.), Tokyo; and the Department of Medicine, Institute of Clinical Endocrinology, Tokyo Women’s Medical University (M.N.), Tokyo, Japan."}]},{"@id":"https://cir.nii.ac.jp/crid/1381699993807112833","@type":"Researcher","foaf:name":[{"@value":"Mitsuhide Naruse"}],"jpcoar:affiliationName":[{"@value":"From the Department of Internal Medicine, Mito Red Cross Hospital (A.S.), Ibaraki; the Department of Internal Medicine, Keio University (K.H., T.S.), Tokyo; and the Department of Medicine, Institute of Clinical Endocrinology, Tokyo Women’s Medical University (M.N.), Tokyo, Japan."}]},{"@id":"https://cir.nii.ac.jp/crid/1381699993807112832","@type":"Researcher","foaf:name":[{"@value":"Takao Saruta"}],"jpcoar:affiliationName":[{"@value":"From the Department of Internal Medicine, Mito Red Cross Hospital (A.S.), Ibaraki; the Department of Internal Medicine, Keio University (K.H., T.S.), Tokyo; and the Department of Medicine, Institute of Clinical Endocrinology, Tokyo Women’s Medical University (M.N.), Tokyo, Japan."}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"0194911X"},{"@type":"EISSN","@value":"15244563"},{"@type":"PISSN","@value":"https://id.crossref.org/issn/0194911X"}],"prism:publicationName":[{"@value":"Hypertension"}],"dc:publisher":[{"@value":"Ovid Technologies (Wolters Kluwer Health)"}],"prism:publicationDate":"2003-01","prism:volume":"41","prism:number":"1","prism:startingPage":"64","prism:endingPage":"68"},"reviewed":"false","dcterms:accessRights":"http://purl.org/coar/access_right/c_abf2","url":[{"@id":"https://www.ahajournals.org/doi/full/10.1161/01.HYP.0000044937.95080.E9"}],"createdAt":"2003-01-03","modifiedAt":"2024-05-12","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=Male","dc:title":"Male"},{"@id":"https://cir.nii.ac.jp/all?q=Heart%20Ventricles","dc:title":"Heart Ventricles"},{"@id":"https://cir.nii.ac.jp/all?q=Angiotensin-Converting%20Enzyme%20Inhibitors","dc:title":"Angiotensin-Converting Enzyme Inhibitors"},{"@id":"https://cir.nii.ac.jp/all?q=Blood%20Pressure","dc:title":"Blood Pressure"},{"@id":"https://cir.nii.ac.jp/all?q=Middle%20Aged","dc:title":"Middle Aged"},{"@id":"https://cir.nii.ac.jp/all?q=Spironolactone","dc:title":"Spironolactone"},{"@id":"https://cir.nii.ac.jp/all?q=Diabetes%20Mellitus,%20Type%202","dc:title":"Diabetes Mellitus, Type 2"},{"@id":"https://cir.nii.ac.jp/all?q=Creatinine","dc:title":"Creatinine"},{"@id":"https://cir.nii.ac.jp/all?q=Albuminuria","dc:title":"Albuminuria"},{"@id":"https://cir.nii.ac.jp/all?q=Humans","dc:title":"Humans"},{"@id":"https://cir.nii.ac.jp/all?q=Diabetic%20Nephropathies","dc:title":"Diabetic Nephropathies"},{"@id":"https://cir.nii.ac.jp/all?q=Drug%20Therapy,%20Combination","dc:title":"Drug Therapy, Combination"},{"@id":"https://cir.nii.ac.jp/all?q=Female","dc:title":"Female"},{"@id":"https://cir.nii.ac.jp/all?q=Aldosterone","dc:title":"Aldosterone"},{"@id":"https://cir.nii.ac.jp/all?q=Mineralocorticoid%20Receptor%20Antagonists","dc:title":"Mineralocorticoid Receptor Antagonists"},{"@id":"https://cir.nii.ac.jp/all?q=Ultrasonography","dc:title":"Ultrasonography"}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1050304183895012480","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"The effect of aldosterone and aldosterone blockade on the progression of chronic kidney disease : a randomized placebo-controlled clinical trial"}]},{"@id":"https://cir.nii.ac.jp/crid/1360004232314971776","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"A serine protease inhibitor attenuates aldosterone-induced kidney injuries via 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antialbuminuric effects of an aldosterone blocker in hypertensive patients with albuminuria"}]},{"@id":"https://cir.nii.ac.jp/crid/1570572700407377408","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isCitedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"Augmentation of Intrarenal Angiotensin II Levels in Uninephrectomized Aldosterone/Salt-Treated Hypertensive Rats ; Renoprotective Effects of an Ultrahigh Dose of Olmesartan"}]},{"@id":"https://cir.nii.ac.jp/crid/1571135651253319296","@type":"Article","relationType":["isCitedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"Activation of the aldosterone/mineralocorticoid receptor system in chronic kidney disease and metabolic syndrome"}]},{"@id":"https://cir.nii.ac.jp/crid/1571417125034546048","@type":"Article","relationType":["isCitedBy"],"jpcoar:relatedTitle":[{"@language":"ja","@value":"Renin 高値が持続した Aldosterone・Cortisol 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