RESEARCH ARTICLE The mineralocorticoid rece eplerenone reduces renal e

slowed the progression of renal dysfunction andDenmark Full list of author information is available at the end of the articleBackground The calcineurin inhibitor cyclosporine A (CsA) is a powerful macrolide immunosuppressive agent widely used after organ transplantation. The calcineurin in-hibitors exert major nephrotoxic effects that involve acute vasoconstriction related to afferent glomerular arterioles as well as a pro-fibrotic effect in the chronic phase [1,2]. Many treatment options have been examined with the purpose of countering these adverse effects, but until recently there have been no single pharmacological approach to prevent the gradual decline in renal function and the progressive renal fibrosis occurring during CsA treatment. There is solid evidence to indicate that aldos-terone aggravates the CsA-induced nephrotoxicity [3-8] and consequently, that mineralocorticoid receptor (MR) blockade might have a preventive effect. In short-term animal studies (up to 21 days) the MR-antagonist spirono