非奈利酮在糖尿病肾病管理中的作用
The Role of Finerenone in the Management of Diabetic Nephropathy.
作者信息
Veneti Stavroula, Tziomalos Konstantinos
机构信息
First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 1 Stilponos Kyriakidi street, 54636, Thessaloniki, Greece.
出版信息
Diabetes Ther. 2021 Jul;12(7):1791-1797. doi: 10.1007/s13300-021-01085-z. Epub 2021 May 29.
Abstract
Diabetic nephropathy (DN) is the leading cause of chronic kidney disease. Even though mineralocorticoid receptor antagonists (MRA) induce incremental reductions in urine albumin excretion when added to angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, this combination is infrequently used because of an increased risk of hyperkalemia. In this context, finerenone, a novel selective MRA that appears to be associated with lower risk for hyperkalemia compared with other MRAs (spironolactone and eplerenone), might represent a useful tool in patients with DN. A recent large randomized trial suggested that finerenone delays the progression of DN and might also reduce cardiovascular morbidity in patients with DN. However, more data are needed to clarify the safety and efficacy of finerenone in this high-risk population.
摘要
糖尿病肾病（DN）是慢性肾脏病的主要病因。尽管在血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂基础上加用盐皮质激素受体拮抗剂（MRA）可使尿白蛋白排泄量逐渐降低，但由于高钾血症风险增加，这种联合用药并不常用。在此背景下，非奈利酮作为一种新型选择性MRA，与其他MRA（螺内酯和依普利酮）相比，似乎与较低的高钾血症风险相关，可能是DN患者的一种有用治疗手段。最近一项大型随机试验表明，非奈利酮可延缓DN进展，还可能降低DN患者的心血管疾病发病率。然而，需要更多数据来阐明非奈利酮在这一高危人群中的安全性和有效性。
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