芬尼酮在心力衰竭高危慢性肾病患者中的应用

IF 10.8 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Metabolism: clinical and experimental Pub Date : 2025-05-13 DOI:10.1016/j.metabol.2025.156297

John P. Hakim , Yehuda Handelsman , Trina Banerjee

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引用次数: 0

摘要

同时患有慢性肾脏疾病（CKD）和2型糖尿病（T2D）的患者的症状性/晚期心力衰竭（HF）的治疗可能包括类固醇矿皮质激素受体拮抗剂（MRA）。然而，CKD和T2D有HF高风险的患者可能受益于非甾体MRA芬尼酮。芬纳酮在伴有T2D的CKD患者中的3期安慰剂对照试验结果显示，芬纳酮（加上肾素-血管紧张素-醛固酮系统抑制剂）降低了新发HF的风险，改善了其他HF结局，并显著减缓了CKD进展。那些从事心脏病学工作的人需要意识到芬烯酮在CKD和T2D患者中降低HF风险的作用。在这篇综述中，我们根据现有的芬尼酮临床试验数据，并从心脏病专家的角度为患有CKD和T2D合并症的患者开芬尼酮处方，提供了在心脏病学中使用芬尼酮的基本原理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Use of finerenone in patients with chronic kidney disease at high risk of heart failure

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Use of finerenone in patients with chronic kidney disease at high risk of heart failure

Treatment of symptomatic/advanced heart failure (HF) in patients who also have chronic kidney disease (CKD) and type 2 diabetes (T2D) may include a steroidal mineralocorticoid receptor antagonist (MRA). However, patients with CKD and T2D who are at high risk of developing HF may benefit from taking the nonsteroidal MRA finerenone. Results from phase 3 placebo-controlled trials of finerenone in patients with CKD associated with T2D showed that finerenone (plus a renin-angiotensin-aldosterone system inhibitor) reduced the risk of new-onset HF, improved other HF outcomes, and caused a significant slowing of CKD progression. Those who work in cardiology need to be aware of the HF risk-reduction effects of finerenone in patients with CKD and T2D. In this review, we provide a rationale for finerenone use in cardiology based on the available finerenone clinical trial data and from the perspective of a cardiologist who prescribes finerenone to patients who have comorbid CKD and T2D.

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来源期刊

Metabolism: clinical and experimental 医学-内分泌学与代谢

CiteScore

18.90

自引率

3.10%

发文量

310

审稿时长

16 days

期刊介绍： Metabolism upholds research excellence by disseminating high-quality original research, reviews, editorials, and commentaries covering all facets of human metabolism. Consideration for publication in Metabolism extends to studies in humans, animal, and cellular models, with a particular emphasis on work demonstrating strong translational potential. The journal addresses a range of topics, including: - Energy Expenditure and Obesity - Metabolic Syndrome, Prediabetes, and Diabetes - Nutrition, Exercise, and the Environment - Genetics and Genomics, Proteomics, and Metabolomics - Carbohydrate, Lipid, and Protein Metabolism - Endocrinology and Hypertension - Mineral and Bone Metabolism - Cardiovascular Diseases and Malignancies - Inflammation in metabolism and immunometabolism