This Month’s Highlights

[摘要] A Novel Rationale for Protein Restriction in CKD. Hyperkalemia and angiotensin II are the classic regulators of aldosterone secretion at the level of promoters in the aldosterone synthase gene. Other pathways for regulation of aldosterone secretion have been described, including dopamine and, transiently, ACTH. The contributions of increased aldosterone secretion to human hypertension, and perhaps to overall cardiovascular outcomes, are well recognized. Khanna and colleagues have described the effects of elevated dietary protein intake on aldosterone secretion, using distal acidification as a read-out, and in this issue of JASN they demonstrate the participation of endogenous endothelin release in this process. That endothelin stimulates aldosterone secretion is an important finding; that dietary protein intake stimulates endothelin secretion is an interesting finding that may be relevant to the dietary recommendations for protein intake in patients with chronic kidney disease. See Khanna et al., pages 1929–1935.

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome