A new study reports that addition of the nonsteroidal mineralocorticoid receptor antagonist finerenone to renin–angiotensin system (RAS) blockade resulted in a reduction in albuminuria in patients with diabetic nephropathy. Such a strategy might provide an opportunity to maximize the beneficial effects of RAS blockade without increasing the risk of hyperkalaemia.
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References
Bakris, G. L. et al. Effect of finerenone on albuminuria in patients with diabetic nephropathy: a randomized clinical trial. JAMA 314, 884–894 (2015).
Cravedi, P., Ruggenenti, P. & Remuzzi, G. Proteinuria should be used as a surrogate in CKD. Nat. Rev. Nephrol. 8, 301–306 (2012).
Lambers Heerspink, H. J., Kropelin, T. F., Hoekman, J. & de Zeeuw, D. Drug-induced reduction in albuminuria Is associated with subsequent renoprotection: a meta-analysis. J. Am. Soc. Nephrol. 26, 2055–2064 (2015).
De Zeeuw, D. et al. Albuminuria, a therapeutic target for CV protection in type 2 diabetic patients with nephropathy. Circulation 110, 921–927 (2004).
Mavrakanas, T. A., Gariani, K. & Martin, P. Y. Mineralocorticoid receptor blockade in addition to angiotensin converting enzyme inhibitor or angiotensin II receptor blocker treatment: an emerging paradigm in diabetic nephropathy: a systematic review. Eur. J. Intern. Med. 25, 173–176 (2014).
Pitt, B. Effect of aldosterone blockade in patients with systolic left ventricular dysfunction: implications of the RALES and EPHESUS studies. Mol. Cell Endocrinol. 217, 53–58 (2004).
Rossing, K., Schjoedt, K. J., Smidt, U. M., Boomsma, F. & Parving, H. H. Beneficial effects of adding spironolactone to recommended antihypertensive treatment in diabetic nephropathy: a randomized, double-masked, cross-over study. Diabetes Care 28, 2106–2112 (2005).
Mehdi, U. F., Adams-Huet, B., Raskin, P., Vega, G. L. & Toto, R. D. Addition of angiotensin receptor blockade or mineralocorticoid antagonism to maximal angiotensin-converting enzyme inhibition in diabetic nephropathy. J. Am. Soc. Nephrol. 20, 2641–2650 (2009).
Kolkhof, P. et al. Finerenone, a novel selective nonsteroidal mineralocorticoid receptor antagonist protects from rat cardiorenal injury. J. Cardiovasc. Pharmacol. 64, 69–78 (2014).
Pitt, B. et al. Safety and tolerability of the novel non-steroidal mineralocorticoid receptor antagonist BAY 94–8862 in patients with chronic heart failure and mild or moderate chronic kidney disease: a randomized, double-blind trial. Eur. Heart J. 34, 2453–2463 (2013).
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Weir, M. Nonsteroidal MRA added to RAS blockade reduces albuminuria. Nat Rev Nephrol 11, 691–692 (2015). https://doi.org/10.1038/nrneph.2015.167
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DOI: https://doi.org/10.1038/nrneph.2015.167
