Aldosterone has been identified in the last decade as an important contributor to the progression of both kidney and heart disease. In elegant experimental studies, Rocha and co-workers [1] demonstrated that aldosterone is responsible for inflammation and fibrosis in the kidney. According to very recent experimental data, spironolactone may induce a regression of existing glomerulosclerosis [2]. In humans, there are few and small studies confirming the beneficial effect of aldosterone antagonism on proteinuria reduction [3–5]. Thus, aldosterone blockade has the theoretic advantage of addressing both heart and kidney damage, a frequent deadly duo.