Mineralocorticoid receptor antagonists for nephroprotection and cardioprotection in patients with diabetes mellitus and chronic kidney disease.

Details

Serval ID
serval:BIB_536AFB717F2D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Mineralocorticoid receptor antagonists for nephroprotection and cardioprotection in patients with diabetes mellitus and chronic kidney disease.
Journal
Nephrology, dialysis, transplantation
Author(s)
Ortiz A., Ferro C.J., Balafa O., Burnier M., Ekart R., Halimi J.M., Kreutz R., Mark P.B., Persu A., Rossignol P., Ruilope L.M., Schmieder R.E., Valdivielso J.M., Del Vecchio L., Zoccali C., Mallamaci F., Sarafidis P.
Working group(s)
European Renal and Cardiovascular Medicine (EURECA-m) working group of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) and the Hypertension and Kidney working group of the European Society of Hypertension (ESH)
ISSN
1460-2385 (Electronic)
ISSN-L
0931-0509
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Diabetic kidney disease develops in about 40% of patients with diabetes and is the commonest cause of chronic kidney disease worldwide. Patients with chronic kidney disease, especially those with diabetes mellitus, are at high risk of both developing kidney failure and cardiovascular death. The use of renin-angiotensin system blockers to reduce the incidence of kidney failure in patients with diabetic kidney disease dates back to studies that are now 20 or more years old. During the last few years sodium-glucose co-transporter-2 inhibitors have shown beneficial renal effects in randomized trials. However, even in response to combined treatment with renin-angiotensin system blockers and sodium-glucose co-transporter-2 inhibitors, the renal residual risk remains high with kidney failure only deferred, but not avoided. The risk of cardiovascular death also remains high even with optimal current treatment. Steroidal mineralocorticoid receptor antagonists reduce albuminuria and surrogate markers of cardiovascular disease in patients already on optimal therapy. However, their use has been curtailed by the significant risk of hyperkalaemia. In The FInerenone in reducing kiDnEy faiLure and dIsease prOgression in Diabetic Kidney Disease (FIDELIO-DKD) study comparing the actions of the non-steroidal mineralocorticoid receptor antagonist finerenone with placebo, finerenone reduced the progression of diabetic kidney disease and the incidence of cardiovascular events with a relatively safe adverse event profile. This document presents in detail the available evidence on the cardioprotective and nephroprotective effects of mineralocorticoid receptor antagonists, analyses the potential mechanisms involved and discusses their potential future place in the treatment of patients with diabetic chronic kidney disease.
Keywords
cardiovascular risk, diabetic kidney disease, hyperkalaemia, mineralocorticoid antagonism, nephroprotection
Pubmed
Web of science
Open Access
Yes
Create date
11/05/2021 13:08
Last modification date
19/03/2022 7:32
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