非甾体矿皮质激素受体拮抗剂：糖尿病肾病管理的范式转变。

IF 2.3 4区医学 Q2 PERIPHERAL VASCULAR DISEASE

Kidney & blood pressure research Pub Date : 2025-03-17 DOI:10.1159/000545286

Justine Huart, François Jouret

{"title":"非甾体矿皮质激素受体拮抗剂：糖尿病肾病管理的范式转变。","authors":"Justine Huart, François Jouret","doi":"10.1159/000545286","DOIUrl":null,"url":null,"abstract":"Background: Diabetic kidney disease (DKD) is the leading cause of chronic kidney disease (CKD) worldwide. The management of DKD relies on controlling glycaemia and blood pressure levels, as well as reducing proteinuria. While the traditional renin-angiotensin-aldosterone system inhibitors (RAASi) and the recently approved Type 2 Na+/Glucose co-transporter inhibitors (SGLT2i) have significantly improved patient outcomes, residual risks remain unaddressed.Summary: This review explores (i) the mechanisms of action of finerenone, a novel non-steroidal mineralocorticoid receptor antagonist (ns-MRA), (ii) the evidence of finerenone-induced kidney protection in clinical trials, and (iii) the comparative advantages over conventional MRAs. The potential synergy between finerenone and SGLT2i is also addressed, alongside research perspectives and practical considerations for implementation in clinical practice.Key messages: Finerenone has emerged as a breakthrough therapy in the management of DKD, demonstrating robust nephron- and cardio-protective effects.","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"1-15"},"PeriodicalIF":2.3000,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Non-steroidal mineralocorticoid receptor antagonists: a paradigm shift in the management of diabetic nephropathy.\",\"authors\":\"Justine Huart, François Jouret\",\"doi\":\"10.1159/000545286\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Diabetic kidney disease (DKD) is the leading cause of chronic kidney disease (CKD) worldwide. The management of DKD relies on controlling glycaemia and blood pressure levels, as well as reducing proteinuria. While the traditional renin-angiotensin-aldosterone system inhibitors (RAASi) and the recently approved Type 2 Na+/Glucose co-transporter inhibitors (SGLT2i) have significantly improved patient outcomes, residual risks remain unaddressed.Summary: This review explores (i) the mechanisms of action of finerenone, a novel non-steroidal mineralocorticoid receptor antagonist (ns-MRA), (ii) the evidence of finerenone-induced kidney protection in clinical trials, and (iii) the comparative advantages over conventional MRAs. The potential synergy between finerenone and SGLT2i is also addressed, alongside research perspectives and practical considerations for implementation in clinical practice.Key messages: Finerenone has emerged as a breakthrough therapy in the management of DKD, demonstrating robust nephron- and cardio-protective effects.\",\"PeriodicalId\":17813,\"journal\":{\"name\":\"Kidney & blood pressure research\",\"volume\":\" \",\"pages\":\"1-15\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-03-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Kidney & blood pressure research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000545286\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Kidney & blood pressure research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000545286","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}

引用次数: 0

摘要

背景：糖尿病肾病（DKD）是世界范围内慢性肾病（CKD）的主要原因。DKD的管理依赖于控制血糖和血压水平，以及减少蛋白尿。虽然传统的肾素-血管紧张素-醛固酮系统抑制剂（RAASi）和最近批准的2型Na+/葡萄糖共转运蛋白抑制剂（SGLT2i）显著改善了患者的预后，但残留的风险仍未得到解决。摘要：本综述探讨了(i)非甾体矿物皮质激素受体拮抗剂（ns-MRA）的作用机制，（ii）临床试验中芬纳酮诱导肾保护的证据，以及（iii）与传统mra相比的比较优势。本文还讨论了芬烯酮和SGLT2i之间潜在的协同作用，以及在临床实践中实施的研究观点和实际考虑。芬尼酮已成为治疗DKD的突破性疗法，显示出强大的肾细胞和心脏保护作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Non-steroidal mineralocorticoid receptor antagonists: a paradigm shift in the management of diabetic nephropathy.

Background: Diabetic kidney disease (DKD) is the leading cause of chronic kidney disease (CKD) worldwide. The management of DKD relies on controlling glycaemia and blood pressure levels, as well as reducing proteinuria. While the traditional renin-angiotensin-aldosterone system inhibitors (RAASi) and the recently approved Type 2 Na+/Glucose co-transporter inhibitors (SGLT2i) have significantly improved patient outcomes, residual risks remain unaddressed.

Summary: This review explores (i) the mechanisms of action of finerenone, a novel non-steroidal mineralocorticoid receptor antagonist (ns-MRA), (ii) the evidence of finerenone-induced kidney protection in clinical trials, and (iii) the comparative advantages over conventional MRAs. The potential synergy between finerenone and SGLT2i is also addressed, alongside research perspectives and practical considerations for implementation in clinical practice.

Key messages: Finerenone has emerged as a breakthrough therapy in the management of DKD, demonstrating robust nephron- and cardio-protective effects.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Kidney & blood pressure research 医学-泌尿学与肾脏学

CiteScore

4.80

自引率

3.60%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal comprises both clinical and basic studies at the interface of nephrology, hypertension and cardiovascular research. The topics to be covered include the structural organization and biochemistry of the normal and diseased kidney, the molecular biology of transporters, the physiology and pathophysiology of glomerular filtration and tubular transport, endothelial and vascular smooth muscle cell function and blood pressure control, as well as water, electrolyte and mineral metabolism. Also discussed are the (patho)physiology and (patho) biochemistry of renal hormones, the molecular biology, genetics and clinical course of renal disease and hypertension, the renal elimination, action and clinical use of drugs, as well as dialysis and transplantation. Featuring peer-reviewed original papers, editorials translating basic science into patient-oriented research and disease, in depth reviews, and regular special topic sections, ''Kidney & Blood Pressure Research'' is an important source of information for researchers in nephrology and cardiovascular medicine.