Key result
Higher aldosterone-renin ratio and lower plasma renin activity linked to lower eGFR in young Black women.
Why the study?
Limited studies exist regarding angiotensinogen and relative aldosterone excess across ethnicities and sex groups in relation to kidney dysfunction.
Do baseline RAAS components predict changes in kidney function differently across ethnicity and sex groups in young adults?
Cohort (n=1,155)
Do baseline RAAS components predict changes in kidney function differently across ethnicity and sex groups in young adults?
p-value: p=≤0.012
Relative aldosterone excess is a predictor of declining kidney function specifically in young Black women, highlighting important sex- and ethnicity-specific pathophysiological mechanisms.
Highlights potential sex- and ethnicity-specific RAAS effects on kidney function; hypothesis-generating and requires prospective confirmation before clinical consideration.
The relationship between kidney dysfunction and the renin angiotensin aldosterone system (RAAS) is known, but limited studies exist on angiotensinogen and relative aldosterone excess across ethnicities and sex groups. We therefore explored cross-sectional and longitudinal associations of kidney function with RAAS components in a population stratified by ethnicity and sex. Materials and methods We included 556 men (Black, n = 283; White, n = 273) and 599 women (Black, n = 293; White, n = 306), with 621 participants followed over 4.9 years. Kidney function was assessed by estimated glomerular filtration rate (eGFR), and Cox regression evaluated whether baseline RAAS components predict lower eGFR (≤25 th percentile) at follow-up. Results At baseline, Black men and women had lower values of RAAS components, including angiotensinogen, and higher eGFR than their White counterparts (all p ≤ 0.016). In cross-sectional analyses, baseline eGFR positively associated with angiotensinogen in White men and women only (all p ≤ 0.036). Lower eGFR at follow-up associated with higher aldosterone to renin ratio (ARR) and lower plasma renin activity and Angiotensin II in Black women only (all p ≤ 0.012). Conclusion In young Black women, higher measures of aldosterone excess relative to renin were associated with a decline in eGFR over time, suggesting potential ethnicity and sex specific influence in aldosterone associated kidney damage.
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Degenaar et al. (2026) conducted a cohort in Kidney function (n=1,155). Relative aldosterone excess (aldosterone to renin ratio) vs. Lower aldosterone to renin ratio was evaluated on Lower eGFR (≤25th percentile) at follow-up (p=≤0.012). Higher aldosterone to renin ratio and lower plasma renin activity were associated with lower eGFR at 4.9-year follow-up in young Black women (p≤0.012).
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