Key result
Mineralocorticoid receptor antagonists provide anti-inflammatory and antifibrotic effects in heart failure and chronic kidney disease, with newer nonsteroidal agents offering greater selectivity.
This review summarizes the mechanisms of steroidal and nonsteroidal MRAs in heart failure with reduced ejection fraction, highlighting the improved selectivity and safety of nonsteroidal agents.
Mineralocorticoid receptor antagonists (MRAs) are one of the guideline-directed medical therapies for patients with heart failure and chronic kidney disease due to their anti-inflammatory and antifibrotic effects. MRAs regulate mineralocorticoid receptor (MR) signaling by inhibiting aldosterone binding to MR. MRAs are classified into steroidal and nonsteroidal categories based on their molecular interactions and clinical applications. Steroidal MRAs have been widely used in clinical practice and have demonstrated significant efficacy. Continuous advancements in the field have led to the development of nonsteroidal MRAs with greater receptor selectivity and better safety profile.
No takes yet. Share an insight, caveat, or question.
Mantri et al. (2026) conducted a review in Heart failure with reduced ejection fraction and chronic kidney disease. Mineralocorticoid receptor antagonists (MRAs) was evaluated. Mineralocorticoid receptor antagonists provide anti-inflammatory and antifibrotic effects in heart failure and chronic kidney disease, with newer nonsteroidal agents offering greater selectivity.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: