Why the study?
Do mineralocorticoid receptor antagonists increase the risk of kidney injury in patients with heart or kidney disease?
Do mineralocorticoid receptor antagonists increase the risk of kidney injury in patients with heart or kidney disease?
Older mineralocorticoid receptor antagonists like canrenone and spironolactone are associated with an increased risk of kidney injury, whereas newer agents like eplerenone and finerenone appear safer for the kidneys.
Answers are grounded in this paper and cite their sources.
May warrant preferring eplerenone or finerenone to minimize kidney injury risk; extends differential MRA safety data.
= 48%, 27,492 patients, 33 RCTs, low certainty). In particular, only canrenone (RR 5.39, 95% CI 2.17-13.37, p < 0.01) and spironolactone (RR 1.78, 95% CI 1.48-2.14, p < 0.01) were associated with an increased risk of kidney injury. However, eplerenone and finerenone seem not to increase the risk of kidney injury in patients with heart or kidney disease. The selection of MRAs might influence the risk of kidney-associated events. Further studies focusing on individual MRAs may be needed to clarify these differences.
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Mitsuboshi et al. (2024) studied this question.
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