Finerenone cardiorenal effects and its placement in treatment of chronic kidney disease in patients with type 2 diabetes mellitus: A review
- 作者: Salukhov V.1, Shamkhalova M.2, Duganova A.1
-
隶属关系:
- Kirov Military Medical Academy
- Endocrinology Research Centre
- 期: 卷 95, 编号 3 (2023)
- 页面: 261-273
- 栏目: Reviews
- URL: https://journals.rcsi.science/0040-3660/article/view/132915
- DOI: https://doi.org/10.26442/00403660.2023.03.202152
- ID: 132915
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详细
Chronic kidney disease (CKD) is one of the most common complications of diabetes mellitus and an independent risk factor for cardiovascular disease. Despite guideline-directed therapy of CKD in patients with type 2 diabetes, the risk of renal failure and cardiovascular events still remains high. To date, current medications for CKD haven’t reduced enough the residual risk associated with inflammation and fibrosis in patients with type 2 diabetes. Here, in this review we present the results of FIDELIO-DKD, FIGARO-DKD trials and their pooled analysis FIDELITY, aimed to evaluate the effectiveness and safety of selective non-steroidal mineralocorticoid receptor antagonist finerenone in patients with type 2 diabetes with wide range stages of CKD. Modern pathophysiological aspects of mineralocorticoid receptor hyperactivation and features of their blockade by steroidal and nonsteroidal mineralocorticoid receptor antagonists are considered, differences in pharmacological effects between them are also discussed, finerenone benefits and its adverse events, demonstrated in randomized clinical trials are considered here. The probable mechanisms of early and delayed action of finerenone, which were realized in beneficial cardiovascular and renal outcomes in patients with type 2 diabetes with CKD, are presented here. Practical points for finerenone initiation and titration are indicated, aimed to minimize the hyperkalemia risk. Current guidelines for CKD treatment in patients with type 2 diabetes are analyzed, the finerenone placement in combined nephroprotective therapy is determined.
作者简介
Vladimir Salukhov
Kirov Military Medical Academy
编辑信件的主要联系方式.
Email: vlasaluk@yandex.ru
ORCID iD: 0000-0003-1851-0941
д-р мед. наук, нач. 1-й каф. и клиники (терапии усовершенствования врачей)
俄罗斯联邦, Санкт-ПетербургMinara Shamkhalova
Endocrinology Research Centre
Email: shamkhalova@mail.ru
ORCID iD: 0000-0002-3433-0142
д-р мед. наук, проф., зав. отд-нием диабетической болезни почек и посттрансплантационной реабилитации
俄罗斯联邦, MoscowAlla Duganova
Kirov Military Medical Academy
Email: alladuganova1@rambler.ru
ORCID iD: 0000-0002-5726-0845
канд. мед. наук, преподаватель 1-й каф. и клиники (терапии усовершенствования врачей) им. акад. Н.С. Молчанова
俄罗斯联邦, Saint Petersburg参考
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