Selective antagonist of mineralocorticoid receptor - new hope for patients with diabetic kidney disease
Abstract
Chronic kidney disease (CKD) usually (since stage CKD3b) unrelentlessly progresses to end-stage kidney disease (ESKD) requiring replacement of kidney function by dialysis or transplantation. Randomized clinical trials demonstrated that the progression of CKD may be in patients with diabetic kidney disease slowed down with the inhibition or renin-angiotensin (RAS) system with either inhibitors of angiotensin-converting enzyme (ACE), or angiotensin receptor blockers (ARB).
Recently published data from FIDELIO-DKD trial showed that the effect of ACE inhibitor or ARB on the amelioration of the progression of CKD in patients with type 2 diabetes may be further potentiated with selective antagonist of mineralocorticoid receptor finerenone. Finerenone emerges for the patients with diabetic kidney disease as a new hope how to delay the need of renal replacement.