Finerenone: A Potential Treatment for Patients with Chronic Kidney Disease and Type 2 Diabetes Mellitus

Type 2 diabetes mellitus (T2DM) affects an estimated 463 million people worldwide, equivalent to 1 in 11 adults. Moreover, the rapid growth of this disease has resulted in a high incidence of diabetic kidney disease (DKD), which, together with hypertension, is the main cause of chronic kidney diseas...

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Autores:: D’Marco, Luis
Puchades, María Jesús
Gandía, Lorena
Forquet, Claudia
Giménez-Civera, Elena
Panizo, Nayara
Reque, Javier
Juan-García, Isabel
Bermúdez, Valmore
Gorriz, José Luis

Tipo de recurso:

Fecha de publicación:: 2021

Institución:: Universidad Simón Bolívar

Repositorio:: Repositorio Digital USB

Idioma:: eng

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dc.title.eng.fl_str_mv	Finerenone: A Potential Treatment for Patients with Chronic Kidney Disease and Type 2 Diabetes Mellitus
title	Finerenone: A Potential Treatment for Patients with Chronic Kidney Disease and Type 2 Diabetes Mellitus
spellingShingle	Finerenone: A Potential Treatment for Patients with Chronic Kidney Disease and Type 2 Diabetes Mellitus Chronic kidney disease cardiovascular diseases diabetic nephropathies finerenone
title_short	Finerenone: A Potential Treatment for Patients with Chronic Kidney Disease and Type 2 Diabetes Mellitus
title_full	Finerenone: A Potential Treatment for Patients with Chronic Kidney Disease and Type 2 Diabetes Mellitus
title_fullStr	Finerenone: A Potential Treatment for Patients with Chronic Kidney Disease and Type 2 Diabetes Mellitus
title_full_unstemmed	Finerenone: A Potential Treatment for Patients with Chronic Kidney Disease and Type 2 Diabetes Mellitus
title_sort	Finerenone: A Potential Treatment for Patients with Chronic Kidney Disease and Type 2 Diabetes Mellitus
dc.creator.fl_str_mv	D’Marco, Luis Puchades, María Jesús Gandía, Lorena Forquet, Claudia Giménez-Civera, Elena Panizo, Nayara Reque, Javier Juan-García, Isabel Bermúdez, Valmore Gorriz, José Luis
dc.contributor.author.none.fl_str_mv	D’Marco, Luis Puchades, María Jesús Gandía, Lorena Forquet, Claudia Giménez-Civera, Elena Panizo, Nayara Reque, Javier Juan-García, Isabel Bermúdez, Valmore Gorriz, José Luis
dc.subject.eng.fl_str_mv	Chronic kidney disease cardiovascular diseases diabetic nephropathies finerenone
topic	Chronic kidney disease cardiovascular diseases diabetic nephropathies finerenone
description	Type 2 diabetes mellitus (T2DM) affects an estimated 463 million people worldwide, equivalent to 1 in 11 adults. Moreover, the rapid growth of this disease has resulted in a high incidence of diabetic kidney disease (DKD), which, together with hypertension, is the main cause of chronic kidney disease (CKD). Hyperglycaemia, low-grade inflammation, altered lipid metabolism and hyperactivation of the renin–angiotensin–aldosterone system (RAAS) seem to be interrelated mechanisms contributing to both T2DM and microvascular complications. The introduction of drugs such as sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists has improved the ability to slow the progression of DKD, and has also demonstrated benefits in cardiovascular disease. Beyond the effects of these novel antidiabetic drugs, a body of evidence suggests that the overactivation of the mineralocorticoid receptor also contributes to CKD progression. Moreover, new and ongoing trials have demonstrated that the selective nonsteroidal mineralocorticoid receptor antagonist (MRA) finerenone improves the risk of CKD progression and cardiovascular events in patients with CKD and T2DM and optimized RAAS blockade. We review the rationale for the development and use of MRA drugs to slow CKD progression in patients with DKD, as well as other pleiotropic effects, and highlight the warnings associated with these agents.
publishDate	2021
dc.date.issued.none.fl_str_mv	2021
dc.date.accessioned.none.fl_str_mv	2022-05-10T12:49:58Z
dc.date.available.none.fl_str_mv	2022-05-10T12:49:58Z
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dc.type.spa.spa.fl_str_mv	Artículo científico
dc.identifier.issn.none.fl_str_mv	27525457
dc.identifier.uri.none.fl_str_mv	https://hdl.handle.net/20.500.12442/9655
dc.identifier.doi.none.fl_str_mv	https://doi.org/10.17925/EE.2021.17.2.84
identifier_str_mv	27525457
url	https://hdl.handle.net/20.500.12442/9655 https://doi.org/10.17925/EE.2021.17.2.84
dc.language.iso.eng.fl_str_mv	eng
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dc.publisher.spa.fl_str_mv	Touch Medical Media
dc.source.none.fl_str_mv	Vol. 17 Num. 2 (2021)
dc.source.eng.fl_str_mv	European Endocrinology
institution	Universidad Simón Bolívar
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spelling	D’Marco, Luisb847abd0-611f-4212-9d68-bf44069a7da7Puchades, María Jesús29344b34-a30c-46ff-bccc-6e990bbbc452Gandía, Lorena4a84eecd-d9eb-4ed5-bfc5-b93e100aa5ceForquet, Claudia0a2705d9-e763-4fc3-a2c0-01aae67af322Giménez-Civera, Elena64ce95d4-12f1-4c19-86e7-420b462adee8Panizo, Nayara00a58d71-17b7-4920-9f6b-7740b5d66002Reque, Javiera1a60ee6-10d9-4c53-a5e6-1b1d909c4e9fJuan-García, Isabel0ac666e1-0239-4767-9c92-2112af4765eaBermúdez, Valmore29f9aa18-16a4-4fd3-8ce5-ed94a0b8663aGorriz, José Luis7aff8528-9549-4596-b47d-945fb22747d82022-05-10T12:49:58Z2022-05-10T12:49:58Z202127525457https://hdl.handle.net/20.500.12442/9655https://doi.org/10.17925/EE.2021.17.2.84Type 2 diabetes mellitus (T2DM) affects an estimated 463 million people worldwide, equivalent to 1 in 11 adults. Moreover, the rapid growth of this disease has resulted in a high incidence of diabetic kidney disease (DKD), which, together with hypertension, is the main cause of chronic kidney disease (CKD). Hyperglycaemia, low-grade inflammation, altered lipid metabolism and hyperactivation of the renin–angiotensin–aldosterone system (RAAS) seem to be interrelated mechanisms contributing to both T2DM and microvascular complications. The introduction of drugs such as sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists has improved the ability to slow the progression of DKD, and has also demonstrated benefits in cardiovascular disease. Beyond the effects of these novel antidiabetic drugs, a body of evidence suggests that the overactivation of the mineralocorticoid receptor also contributes to CKD progression. Moreover, new and ongoing trials have demonstrated that the selective nonsteroidal mineralocorticoid receptor antagonist (MRA) finerenone improves the risk of CKD progression and cardiovascular events in patients with CKD and T2DM and optimized RAAS blockade. We review the rationale for the development and use of MRA drugs to slow CKD progression in patients with DKD, as well as other pleiotropic effects, and highlight the warnings associated with these agents.pdfengTouch Medical MediaAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Vol. 17 Num. 2 (2021)European EndocrinologyChronic kidney diseasecardiovascular diseasesdiabetic nephropathiesfinerenoneFinerenone: A Potential Treatment for Patients with Chronic Kidney Disease and Type 2 Diabetes Mellitusinfo:eu-repo/semantics/articleArtículo científicohttp://purl.org/coar/version/c_970fb48d4fbd8a85http://purl.org/coar/resource_type/c_2df8fbb1Rowley WR, Bezold C, Arikan Y, et al. Diabetes 2030: Insights from yesterday, today, and future trends. Popul Health Manag. 2017;20:6–12Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019;157:107843Buse JB, Wexler DJ, Tsapas A, et al. 2019 update to: Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2020;63:221–8. Correction in: Diabetologia. 2020;63:1667.Perkovic V, Jardine MJ, Neal B, et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med. 2019;380:2295–306Agarwal R, Kolkhof P, Bakris G, et al. Steroidal and non-steroidal mineralocorticoid receptor antagonists in cardiorenal medicine. Eur Heart J. 2021;42:152–61Liu LC, Schutte E, Gansevoort RT, et al. Finerenone: Third-generation mineralocorticoid receptor antagonist for the treatment of heart failure and diabetic kidney disease. Expert Opin Investig Drugs. 2015;24:1123–35.Bakris GL, Agarwal R, Anker SD, et al. Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes. N Engl J Med.2020;383:2219–29.Pitt B, Filippatos G, Agarwal R, et al. Cardiovascular events with finerenone in kidney disease and type 2 diabetes. N Engl J Med. doi: 10.1056/NEJMoa2110956Carlström M. Nitric oxide signalling in kidney regulation and cardiometabolic health. Nat Rev Nephrol. 2021;17:575–90Go AS, Yang J, Tan TC, et al. Contemporary rates and predictors of fast progression of chronic kidney disease in adults with and without diabetes mellitus. BMC Nephrol.2018;19:146.Jankowski J, Floege J, Fliser D, et al. Cardiovascular disease in chronic kidney disease: Pathophysiological insights and therapeutic options. Circulation. 2021;143:1157–72.Yang T, Richards EM, Pepine CJ, Raizada MK. The gut microbiota and the brain–gut–kidney axis in hypertension and chronic kidney disease. Nat Rev Nephrol.2018;14:442–56Whaley-Connell A, Sowers JR. Basic science: Pathophysiology: The cardiorenal metabolic syndrome. J Am Soc Hypertens. 2014;8:604–6.American Diabetes Association. 11. Microvascular complications and foot care: standards of medical care in diabetes − 2020. Diabetes Care.2020;43(Suppl. 1):S135–51.American Diabetes Association. 11. Microvascular complications and foot care: standards of medical care in diabetes − 2020. Diabetes Care.2020;43(Suppl. 1):S135–51Ortiz A, Ferro CJ, Balafa O, et al. Mineralocorticoid receptor antagonists for nephroprotection and cardioprotection in patients with diabetes mellitus and chronic kidney disease. Nephrol Dial Transplant. 2021;4;gfab167. doi: 10.1093/ndt/gfab167Pitt B, Anker SD, Böhm M, et al. Rationale and design of MinerAlocorticoid Receptor antagonist Tolerability Study-Heart Failure (ARTS-HF): A randomized study of finerenone vs. eplerenone in patients who have worsening chronic heart failure with diabetes and/or chronic kidney disease. Eur J Heart Fail. 2015;17:24–32.Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. N Engl J Med.1999;341:709–17.Pitt B, Remme W, Zannad F, et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 2003;348:1309–21.Preiss D, van Veldhuisen DJ, Sattar N, et al. Eplerenone and new-onset diabetes in patients with mild heart failure: Results from the Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure (EMPHASIS-HF). Eur J Heart Fail. 2012;14:909–15.Barrera-Chimal J, Girerd S, Jaisser F. Mineralocorticoid receptor antagonists and kidney diseases: pathophysiological basis. Kidney Int. 2019;96:302–19.Agarwal R, Anker SD, Bakris G, et al. Investigating new treatment opportunities for patients with chronic kidney disease in type 2 diabetes: The role of finerenone. Nephrol Dial Transplant.2020;gfaa294. doi: 10.1093/ndt/gfaa294Agarwal R, Anker SD, Bakris G, et al. Investigating new treatment opportunities for patients with chronic kidney disease in type 2 diabetes: The role of finerenone. Nephrol Dial Transplant.2020;gfaa294. doi: 10.1093/ndt/gfaa294Agarwal R, Anker SD, Bakris G, et al. Investigating new treatment opportunities for patients with chronic kidney disease in type 2 diabetes: The role of finerenone. Nephrol Dial Transplant.2020;gfaa294. doi: 10.1093/ndt/gfaa294Orena S, Maurer TS, She L, et al. PF-03882845, a non-steroidal mineralocorticoid receptor antagonist, prevents renal injury with reduced risk of hyperkalemia in an animal model of nephropathy. Front Pharmacol. 2013;4:115.Huang LL, Nikolic-Paterson DJ, Han Y, et al. Myeloid mineralocorticoid receptor activation contributes to progressive kidney disease. J Am Soc Nephrol. 2014;25:2231–40.Ayuzawa N, Fujita T. The mineralocorticoid receptor in salt-sensitive hypertension and renal injury. J Am Soc Nephrol. 2021;32:279–89.Provenzano M, Puchades M, Nicola L, et al. Study design of the rotation for optimal targeting of albuminuria and treatment evaluation (ROTATE-3): A rotation study of different albuminuria lowering drugs classes to study individual drug response in diabetic and non-diabetic CKD. Nephrol Dial Transplant. 2020;35(Suppl.):1003.Navaneethan SD, Nigwekar SU, Sehgal AR, Strippoli GFM. Aldosterone antagonists for preventing the progression of chronic kidney disease: A systematic review and meta-analysis. Clin J Am Soc Nephrol.2009;4:542–51Gorriz JL, D’Marco L, Pastor-González A, et al. Long-term mortality and trajectory of potassium measurements following an episode of acute severe hyperkalaemia. Nephrol Dial Transplant. 2021 Jan 28:gfab003. doi: 10.1093/ndt/gfab003Morillas C, D’Marco L, Puchades MJ, et al. Insulin withdrawal in diabetic kidney disease: what are we waiting for? 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Finerenone: A Potential Treatment for Patients with Chronic Kidney Disease and Type 2 Diabetes Mellitus

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