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Review Article
Diabetes, Obesity and Metabolism
Renal Protection of Mineralocorticoid Receptor Antagonist, Finerenone, in Diabetic Kidney Disease
Dong-Lim Kim, Seung-Eun Lee, Nan Hee Kim
Endocrinol Metab. 2023;38(1):43-55.   Published online February 27, 2023
DOI: https://doi.org/10.3803/EnM.2022.1629
  • 26,342 View
  • 1,473 Download
  • 41 Web of Science
  • 44 Crossref
AbstractAbstract PDFPubReader   ePub   
Chronic kidney disease (CKD) is the most common cause of end-stage renal disease in patients with type 2 diabetes mellitus (T2DM). CKD increases the risk of cardiovascular diseases; therefore, its prevention and treatment are important. The prevention of diabetic kidney disease (DKD) can be achieved through intensive glycemic control and blood pressure management. Additionally, DKD treatment aims to reduce albuminuria and improve kidney function. In patients with T2DM, renin-angiotensin-aldosterone system inhibitors, sodium glucose cotransporter 2 inhibitors, and glucagon-like peptide-1 receptor agonists can delay the progression of DKD. Hence, there is a need for novel treatments that can effectively suppress DKD progression. Finerenone is a first-in-class nonsteroidal mineralocorticoid receptor antagonist with clinically proven efficacy in improving albuminuria, estimated glomerular filtration rate, and risk of cardiovascular events in early and advanced DKD. Therefore, finerenone is a promising treatment option to delay DKD progression. This article reviews the mechanism of renal effects and major clinical outcomes of finerenone in DKD.

Citations

Citations to this article as recorded by  
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    Gerry George Mathew
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    Frontiers in Endocrinology.2026;[Epub]     CrossRef
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    Tham Thi Bui, So-Hyeon Kim, Woojin Jung, Sung-yoon Yang, Quyen Thi Tran, Hyunjung Lee, Seongwon Park, Lien Thi Ngo, Hwi-yeol Yun, Jung-woo CHAE
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  • Novel Approaches in Chronic Renal Failure without Renal Replacement Therapy: A Review
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Brief Report
Diabetes, Obesity and Metabolism
Cardiovascular Outcomes with Finerenone According to Glycemic Status at Baseline and Prior Treatment with Newer Antidiabetics among Patients with Type 2 Diabetes Mellitus
Dimitrios Patoulias, Christodoulos Papadopoulos, Asterios Karagiannis, Vassilios Vassilikos, Michael Doumas
Endocrinol Metab. 2022;37(1):170-174.   Published online February 9, 2022
DOI: https://doi.org/10.3803/EnM.2021.1296
  • 8,759 View
  • 236 Download
  • 6 Web of Science
  • 7 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Type 2 diabetes mellitus (T2DM) and cardiovascular disease are closely interconnected. We sought to determine the cardioprotective action of finerenone according to prior treatment with newer antidiabetics and glycemic status. We searched PubMed and Cochrane Library from inception to October 1, 2021 for randomized controlled trials (RCTs) assessing the effect of finerenone on major adverse cardiovascular outcomes in patients with T2DM. We set the primary endpoint as major adverse cardiovascular events (MACE), defined as the composite of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. We finally included two RCTs in our quantitative synthesis. Compared to placebo, finerenone induced a 23% risk reduction for the composite cardiovascular endpoint, regardless of prior glycemia. We also showed that finerenone provided significant cardiovascular benefit for obese patients with T2DM compared to placebo, although this benefit was diminished for subjects with a body mass index lower than 30 kg/m2. Finally, the combination of finerenone with sodium-glucose co-transporter-2 inhibitors or glucagon-like peptide-1 receptor agonists did not produce a significant risk reduction for MACE. We conclude that finerenone provides significant cardiovascular benefits for patients with T2DM, especially for those who are obese, while glycemic status or treatment with newer antidiabetics at baseline does not affect the observed cardioprotective action.

Citations

Citations to this article as recorded by  
  • Effectiveness and safety of chronic diuretic use in older adults: an umbrella review of recently published systematic reviews and meta-analyses of randomized-controlled trials
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  • Finerenone in Chronic Kidney Disease: A Comprehensive Review of Mechanisms, Efficacy and Safety
    Yonglu Hu, Chengqian Li, Shufa Li, Lili Xu, Yangang Wang, Bingzi Dong
    Diabetes/Metabolism Research and Reviews.2025;[Epub]     CrossRef
  • OPTIMIZING ANTIHYPERTENSIVE THERAPY IN CHRONIC KIDNEY DISEASE (CKD) PATIENTS: A REVIEW OF DOSE ADJUSTMENTS AND CLINICAL CONSIDERATIONS
    KANCHAN SHELKE, TEJAS PARKHE, DHANRAJ SHINDE
    International Journal of Pharmacy and Pharmaceutical Sciences.2025; : 25.     CrossRef
  • Finerenone protects against progression of kidney and cardiovascular damage in a model of type 1 diabetes through modulation of proinflammatory and osteogenic factors
    M. Sanz-Gómez, F.J. Manzano-Lista, E. Vega-Martín, D. González-Moreno, M. Alcalá, M. Gil-Ortega, B. Somoza, C. Pizzamiglio, L.M. Ruilope, I. Aránguez, P. Kolkhof, R. Kreutz, M.S. Fernández-Alfonso
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  • Research Progress in Finerenone in Cardiovascular Diseases
    Sun Xue, Dong Yanghong, Gu Jiaxin, Liu Wenxiu, Liu Yue
    Cardiovascular Innovations and Applications.2023;[Epub]     CrossRef
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