Cardiorenal benefits of finerenone: protecting kidney and heart.

Publisher: Informa Healthcare Country of Publication: England NLM ID: 8906388 Publication Model: Print Cited Medium: Internet ISSN: 1365-2060 (Electronic) Linking ISSN: 07853890 NLM ISO Abbreviation: Ann Med Subsets: MEDLINE

Publication: London : Informa Healthcare
Original Publication: Helsinki : Finnish Medical Society Duodecim, 1989-

Diabetes Mellitus, Type 2*/complications ; Diabetes Mellitus, Type 2*/drug therapy ; Diabetic Nephropathies*/complications ; Renal Insufficiency, Chronic*/complications ; Renal Insufficiency, Chronic*/drug therapy ; Cardiovascular Diseases*/prevention & control ; Cardiovascular Diseases*/complications; Humans ; Mineralocorticoid Receptor Antagonists/therapeutic use ; Receptors, Mineralocorticoid/therapeutic use ; Albuminuria/complications ; Kidney ; Fibrosis ; Inflammation/drug therapy ; Glucose ; Sodium/therapeutic use

Persons with diabetes and chronic kidney disease (CKD) have a high residual risk of developing cardiovascular (CV) complications despite treatment with renin-angiotensin system blockers and sodium-glucose cotransporter type 2 inhibitors. Overactivation of mineralocorticoid receptors plays a key role in the progression of renal and CV disease, mainly by promoting inflammation and fibrosis. Finerenone is a nonsteroidal selective mineralocorticoid antagonist. Recent clinical trials, such as FIDELIO-DKD and FIGARO-DKD and the combined analysis FIDELITY have demonstrated that finerenone decreases albuminuria, risk of CKD progression, and CV risk in subjects with type 2 diabetes (T2D) and CKD. As a result, finerenone should thus be considered as part of a holistic approach to kidney and CV risk in persons with T2D and CKD. In this narrative review, the impact of finerenone treatment on the CV system in persons with type 2 diabetes and CKD is analyzed from a practical point of view.Key messages:Despite inhibition of renin-angiotensin system and sodium-glucose cotransporter type 2, persons with type 2 diabetes (T2D) and chronic kidney disease (CKD) remain on high cardiovascular (CV) residual risk.Overactivation of mineralocorticoid receptors plays a key role in the progression of renal and CV disease, mainly by promoting inflammation and fibrosis that is not targeted by traditional treatments.Finerenone is a nonsteroidal selective mineralocorticoid antagonist that decreases not only albuminuria, but also the risk of CKD progression, and CV risk in subjects with T2D and CKD.

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Keywords: Albuminuria; cardiovascular; chronic kidney disease; finerenone; inflammation; type 2 diabetes

0 (Mineralocorticoid Receptor Antagonists)
0 (Receptors, Mineralocorticoid)
0 (finerenone)
IY9XDZ35W2 (Glucose)
9NEZ333N27 (Sodium)

Date Created: 20230131 Date Completed: 20230201 Latest Revision: 20240119

20240119

PMC9891162

10.1080/07853890.2023.2171110

36719097