Key result
Mineralocorticoid receptor antagonists, particularly finerenone, effectively reduce cardiovascular events, death, and the incidence of end-stage kidney disease in patients with type 2 diabetes.
Why the study?
A high residual risk of CKD progression and cardiovascular events remains under RAS blockade in DKD, prompting interest in the nephroprotective and cardioprotective roles of mineralocorticoid receptor antagonists.
Do mineralocorticoid receptor antagonists provide nephroprotection and cardioprotection in patients with diabetic kidney disease?
Do mineralocorticoid receptor antagonists provide nephroprotection and cardioprotection in patients with diabetic kidney disease?
Mineralocorticoid receptor antagonists, particularly the novel nonsteroidal agent finerenone, offer significant nephroprotective and cardioprotective benefits in patients with diabetic kidney disease.
May support finerenone in diabetic kidney disease; leaves open confirmation from prospective randomized trials.
Diabetic kidney disease (DKD) represents a major public health issue, currently posing an important burden on healthcare systems. Renin–angiotensin system (RAS) blockers are considered the cornerstone of treatment of albuminuric DKD. However, a high residual risk of progression to more advanced CKD stages under RAS blockade still remains, while relevant studies did not show significant declines in cardiovascular events with these agents in patients with DKD. Among several other pharmacological classes, mineralocorticoid receptor antagonists (MRAs) have received increasing interest, due to a growing body of high-quality evidence showing that spironolactone and eplerenone can significantly lower blood pressure and albuminuria in patients with CKD. Furthermore, finerenone, a novel nonsteroidal MRA with unique physicochemical properties, was shown to effectively reduce cardiovascular events and death, as well as the incidence of end-stage kidney disease in patients with type 2 diabetes. This review discusses previous and recent clinical evidence on the issue of nephroprotection and cardioprotection in DKD offered by mineralocorticoid receptor antagonism, aiming to aid clinicians in their treatment decisions for diabetic patients.
No takes yet. Share an insight, caveat, or question.
Alexandrou et al. (2022) conducted a review in Diabetic Kidney Disease. Mineralocorticoid Receptor Antagonists was evaluated. Mineralocorticoid receptor antagonists, particularly finerenone, effectively reduce cardiovascular events, death, and the incidence of end-stage kidney disease in patients with type 2 diabetes.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: