Hyperaldosteronism has been noted as a component of clinical chronic renal insufficiency of various etiologies. In a cross sectional study of patients with mild to moderate renal insufficiency Hene et al observed that level of serum aldosterone increased as creatinine clearance fell below 70 cc/min and went up as high as 3-4 fold the baseline. Similarly in a study of 9 patients with average inulin clearance of 27cc/min, Bauer and Reams noted plasma aldosterone level to be four fold greater than normal. The significance of this Hyperaldosteronism as to the progression of the renal insufficiency had not been studied systematically, but in one longitudinal study Walker noted a significant correlation between aldosterone level and rate of progression of renal failure. In this longitudinal study of 131 diabetic cohort, Walker noted that hypertension, plasma angiotensin II and aldosterone were independent predictors of accelerated loss of renal function.