Finerenone and diabetic renal disease: a narrative review.

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Pub Date : 2024-12-01 Epub Date: 2024-08-14 DOI:10.1007/s12020-024-03945-7

Kirthika Venkatesan, Mabel Mary James Cheryeth, Anna Tintu Verghese, Arpita Mariam Mathews, Nikitha Ravisankar, Parvathy Unnikrishnan, Vishakh Prakash, Hridya Harimohan, Nisha Nigil Haroon, Sandra James, Somy Cherian

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Abstract

Overactivation of mineralocorticoid receptors occurs in cardiorenal diseases. Many patients with type 2 diabetes often progress to chronic kidney disease (CKD) and require dialysis. Finerenone is the first oral non-steroidal mineralocorticoid receptor (MR) antagonist used in patients with diabetic kidney disease and heart failure. Finerenone (also known as Kerendia) is more potent than spironolactone in reducing the progression of CKD and exerts its effect equally on the heart and kidneys, improving cardiovascular outcomes. Research demonstrates that finerenone improves proteinuria and glomerular filtration rate (GFR) if taken alone or in combination with sodium-glucose transporter 2 inhibitors (SGLT2i). Finerenone has been found to decrease mortality in patients with diabetic renal disease and improve quality of life. Its side effects, unlike those of spironolactone, do not include gynecomastia. However, it can result in hyperkalemia, which needs to be monitored. In this narrative review, we aim to investigate the mechanisms of action of finerenone and its implications in patients with type 2 diabetes.

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非格列酮与糖尿病肾病：叙述性综述。

心肾疾病会导致矿皮质激素受体过度激活。许多 2 型糖尿病患者通常会发展为慢性肾脏病（CKD），需要进行透析治疗。非格列酮（Finerenone）是首个用于糖尿病肾病和心力衰竭患者的口服非甾体类矿物皮质激素受体（MR）拮抗剂。与螺内酯相比，非奈酮（又名凯伦帝亚）在减少慢性肾功能衰竭进展方面的作用更强，而且对心脏和肾脏的作用相同，可改善心血管预后。研究表明，如果单独服用或与钠-葡萄糖转运体 2 抑制剂（SGLT2i）联合使用，非格列酮能改善蛋白尿和肾小球滤过率（GFR）。研究发现，非格列酮能降低糖尿病肾病患者的死亡率，改善生活质量。与螺内酯不同，非奈酮的副作用不包括妇科肿瘤。然而，它可能导致高钾血症，需要加以监测。在这篇叙述性综述中，我们旨在研究非奈酮的作用机制及其对 2 型糖尿病患者的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.