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Updated: May 21, 2025

Author Spotlight: Network Pharmacology and Molecular Docking to Decipher the Action of Jiawei Shengjiang San Against Diabetic Kidney Disease
Published on: May 10, 2024
Non-Steroidal Mineralocorticoid Receptor Antagonists: A Paradigm Shift in the Management of Diabetic Nephropathy
Justine Huart1,2, François Jouret1,2
1Division of Nephrology, University of Liège Hospital (ULiège CHU), Liège, Belgium.
Background:
Diabetic kidney disease (DKD) is the leading cause of chronic kidney disease worldwide. The management of DKD relies on controlling glycemia and blood pressure levels, as well as reducing proteinuria. While the traditional renin-angiotensin-aldosterone system inhibitors (RAASi) and the recently approved type 2 Na+/glucose co-transporter inhibitors (SGLT2i) have significantly improved patient outcomes, residual risks remain unaddressed.
Summary:
This review explores (1) the mechanisms of action of finerenone, a novel non-steroidal mineralocorticoid receptor antagonist (ns-MRA), (2) the evidence of finerenone-induced kidney protection in clinical trials, and (3) the comparative advantages over conventional MRAs. The potential synergy between finerenone and SGLT2i is also addressed, alongside research perspectives and practical considerations for implementation in clinical practice.
Key Messages:
Finerenone has emerged as a breakthrough therapy in the management of DKD, demonstrating robust nephro- and cardio-protective effects.
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