In conclusion, we performed in vitro and in vivo experiments and showed that ALD-mediated MR activation upregulated the expression of TGF-β1 and induced the transformation of macrophages, especially M1 macrophages, to myofibroblasts to participate in renal fibrosis, and the MR blocker esaxerenone antagonized these effects. This evidence concerns the gene TGFB1 and renal fibrosis.