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Finerenone: towards a holistic therapeutic approach to patients with diabetic kidney disease

Jose Luis Górriz1, José Ramón González-Juanatey2, Lorenzo Facila3

  • 1Servicio de Nefrología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, Spain.

Nefrologia
|October 9, 2023
PubMed

Insights

Finerenone, a novel mineralocorticoid antagonist, effectively reduces albuminuria and slows chronic kidney disease (CKD) progression in diabetic patients. This offers new hope for managing kidney disease alongside existing therapies.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Diabetic kidney disease (DKD) progression remains high despite current treatments like renin-angiotensin system blockers and SGLT2 inhibitors.
  • DKD pathogenesis involves complex hemodynamic, metabolic, inflammatory, and fibrotic pathways.
  • There is a need for therapies that target inflammation and fibrosis directly.

Purpose of the Study:

  • To review the mechanism of action of finerenone, a selective non-steroidal mineralocorticoid antagonist.
  • To summarize the results of recent clinical trials evaluating finerenone in diabetic patients with CKD.
  • To discuss the integration of finerenone for kidney and cardiovascular protection in routine care.

Main Methods:

  • Review of existing literature on finerenone's mechanism of action.
  • Analysis of data from key clinical trials involving finerenone.
  • Synthesis of evidence regarding finerenone's impact on albuminuria, CKD progression, and cardiovascular outcomes.

Main Results:

  • Finerenone demonstrates a high selectivity for the mineralocorticoid receptor.
  • Clinical trials show finerenone reduces albuminuria and slows the progression of CKD in patients with diabetes.
  • Finerenone offers potential benefits for both kidney and cardiovascular protection.

Conclusions:

  • Finerenone represents a valuable addition to the management of diabetic kidney disease.
  • Its ability to target inflammation and fibrosis offers a distinct advantage over current therapies.
  • Integration into routine care may improve outcomes for patients with diabetes and CKD.

Keywords:
AlbuminuriaChronic kidney diseaseDiabetesEnfermedad renal crónicaFibrosisFinerenonaFinerenoneInflamaciónInflammation

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