Vascular calcification (VC) is a strong predictor of cardiovascular morbidity and mortality, and is linked to ageing, diabetes and chronic kidney diseases (CKD). 1 Growing evidence now suggests that VC is an actively regulated process resembling bone remodelling, including both inductive and inhibitory processes. 2 Abnormal activation of the renin-angiotensin-aldosterone system plays an important role in the development of cardiovascular diseases, among which aldosterone (Aldo) is a major effector. 3 Aldo, a mineralocorticoid hormone, binds to mineralocorticoid receptor (MR) and then activates specific intracellular genomic pathways, thus regulating the homeostasis of the cardiovascular system. Once Aldo is overactivated, it can promote vascular oxidative stress, inflammation and apoptosis, 4 leading to an increased risk of target-organ damage. 5 Previous studies suggested that a MR inhibitor, spironolactone (Spiro) ameliorated CKD-related
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