Findings highlight how finerenone reduces albuminuria in diabetic kidney disease, suggesting a potential therapeutic pathway.
Finerenone, a non-steroidal selective mineralocorticoid receptor antagonist (nsMRA), has demonstrated renoprotective effects in patients with chronic kidney disease (CKD) and type 2 diabetes, as shown in the FIDELIO-DKD study. However, the underlying physiological mechanism responsible for its albuminuria-reducing effect remains incompletely understood. Animal studies have reported that excessive activation of mineralocorticoid receptors (MRs) in glomerular cells contributes to the progression of diabetic kidney disease (DKD) and albuminuria, and is also associated with metabolic abnormalities such as hypertension, heart failure, and type 2 diabetes.
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Iwakura et al. (2026) studied this question.
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