Abstract-Aldosterone is implicated in the pathogenesis of proteinuria and chronic kidney disease. We previously demonstrated the contribution of elevated serum aldosterone in the early nephropathy of SHR/NDmcr-cp (SHR/cp), a rat model of metabolic syndrome. In the present study, we investigated the effect of salt loading on renal damage in SHR/cps and explored the underlying mechanisms. SHR/cps fed a high-sodium diet for 4 weeks developed severe hypertension, massive proteinuria, and advanced renal lesions. High salt also worsened glomerular podocyte impairment. Surprisingly, selective mineralocorticoid receptor (MR) antagonist eplerenone dramatically ameliorated the salt-induced proteinuria and renal injury in SHR/cps. Although salt loading reduced circulating aldosterone, it increased nuclear MR and expression of aldosterone effector kinase Sgk1 in the kidney. Gene expressions of transforming growth factor-1 and plasminogen activator inhibitor-1 were also enhanced in the kidneys of salt-loaded SHR/cps, and eplerenone completely inhibited these injury markers. To clarify the discrepancy between decreased aldosterone and enhanced MR signaling by salt, we further investigated the role of oxidative stress, a putative key factor mediating salt-induced tissue damage. Interestingly, antioxidant Tempol attenuated the salt-evoked MR upregulation and Sgk1 induction and alleviated proteinuria and renal histological abnormalities, suggesting the involvement of oxidative stress in salt-induced MR activation. MR activation by salt was not attributed to increased serum corticosterone or reduced 11-hydroxysteroid dehydrogenase type 2 activity. In conclusion, sodium loading exacerbated proteinuria and renal injury in metabolic syndrome rats. Salt reduced circulating aldosterone but caused renal MR activation at least partially via induction of oxidative stress, and eplerenone effectively improved the nephropathy. Key Words: aldosterone Ⅲ mineralocorticoids Ⅲ metabolic syndrome Ⅲ sodium Ⅲ dietary Ⅲ oxidative stress (kidney) Ⅲ chronic kidney disease Ⅲ proteinuria Ⅲ eplerenone S alt plays an important role in the progression of target organ injury, as well as in the pathogenesis of hypertension. Epidemiologic studies revealed that higher sodium intake increases the risk of cardiovascular disease, independent of other risk factors, 1 and causes poor prognosis of renal disease. 2 Experimental animal studies indicated that increased dietary salt promotes renal fibrosis and progression of kidney disease. 3,4 The deleterious effects of salt are, at least partially, independent of blood pressure (BP). 1,2,4 Susceptibility to salt is reported to be augmented in certain disease conditions. For example, high salt exacerbates proteinuria in overweight but not nonoverweight subjects. 5 However, the underlying mechanisms have not been clearly elucidated.Accumulating evidence suggests that aldosterone is an important pathogenetic factor in the progression of renal disease and heart failure. 6 In the kidney, aldosterone was demonstrated to ...