Finerenone: A Potential Treatment for Patients with Chronic Kidney Disease and Type 2 Diabetes Mellitus
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Fecha
2021
Autores
D’Marco, Luis
Puchades, María Jesús
Gandía, Lorena
Forquet, Claudia
Giménez-Civera, Elena
Panizo, Nayara
Reque, Javier
Juan-García, Isabel
Bermúdez, Valmore
Gorriz, José Luis
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Touch Medical Media
Resumen
Type 2 diabetes mellitus (T2DM) affects an estimated 463 million people worldwide, equivalent to 1 in 11 adults. Moreover, the rapid
growth of this disease has resulted in a high incidence of diabetic kidney disease (DKD), which, together with hypertension, is the
main cause of chronic kidney disease (CKD). Hyperglycaemia, low-grade inflammation, altered lipid metabolism and hyperactivation
of the renin–angiotensin–aldosterone system (RAAS) seem to be interrelated mechanisms contributing to both T2DM and microvascular
complications. The introduction of drugs such as sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists
has improved the ability to slow the progression of DKD, and has also demonstrated benefits in cardiovascular disease. Beyond the effects
of these novel antidiabetic drugs, a body of evidence suggests that the overactivation of the mineralocorticoid receptor also contributes to
CKD progression. Moreover, new and ongoing trials have demonstrated that the selective nonsteroidal mineralocorticoid receptor antagonist
(MRA) finerenone improves the risk of CKD progression and cardiovascular events in patients with CKD and T2DM and optimized RAAS
blockade. We review the rationale for the development and use of MRA drugs to slow CKD progression in patients with DKD, as well as other
pleiotropic effects, and highlight the warnings associated with these agents.
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Palabras clave
Chronic kidney disease, cardiovascular diseases, diabetic nephropathies, finerenone
