Role of Mineralocorticoid Receptor Antagonists in Diabetic Kidney Disease

被引:4
|
作者
Alexandrou, Maria-Eleni [1 ]
Theodorakopoulou, Marieta P. [1 ]
Sarafidis, Pantelis A. [1 ]
机构
[1] Aristotle Univ Thessaloniki, Hippokrat Hosp, Dept Nephrol, GR-54642 Thessaloniki, Greece
来源
KIDNEY AND DIALYSIS | 2022年 / 2卷 / 02期
关键词
diabetic kidney disease (DKD); mineralocorticoid receptor antagonists (MRAs); finerenone; spironolactone; eplerenone; esaxerenone; nephroprotection; albuminuria; end-stage kidney disease (ESKD); cardioprotection; URINARY ALBUMIN EXCRETION; ANGIOTENSIN-ALDOSTERONE SYSTEM; DOUBLE-BLIND; CARDIOVASCULAR OUTCOMES; RESISTANT HYPERTENSION; ESAXERENONE CS-3150; BENEFICIAL IMPACT; OXIDATIVE STRESS; ADDITIVE THERAPY; BLOOD-PRESSURE;
D O I
10.3390/kidneydial2020019
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:163 / 182
页数:20
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