Finerenone: A Potential Treatment for Patients with Chronic Kidney Disease and Type 2 Diabetes Mellitus

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 diseas...

Descripción completa

Detalles Bibliográficos
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
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:Colombia
Institución:Universidad Simón Bolívar
Repositorio:Repositorio Digital USB
Idioma:inglés
OAI Identifier:oai:bonga.unisimon.edu.co:20.500.12442/9655
Acceso en línea:https://hdl.handle.net/20.500.12442/9655
https://doi.org/10.17925/EE.2021.17.2.84
Access Level:acceso abierto
Palabra clave:Chronic kidney disease
cardiovascular diseases
diabetic nephropathies
finerenone
Descripción
Sumario: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.