Oshima Akira, Imamura Teruhiko, Narang Nikhil, Kinugawa Koichiro
Second Department of Internal Medicine, University of Toyama Toyama Japan.
Advocate Christ Medical Center Oak Lawn, IL USA.
Circ Rep. 2021 May 12;3(6):333-337. doi: 10.1253/circrep.CR-21-0024.
The effects of mineralocorticoid receptor antagonists, including the newly introduced esaxerenone, on renal function remain uncertain. This retrospective study was performed on patients who received esaxerenone for resistant hypertension between November 2019 and June 2020. Trends in the estimated glomerular filtration rate (eGFR) were compared between the 6-month period before esaxerenone treatment (pre-treatment period) and the 6-month treatment period on esaxerenone. Twenty-six patients (15 men), with a median age of 70 years (interquartile range [IQR] 51-73 years) and a median systolic blood pressure of 146 mmHg (IQR 139-156 mmHg), were included in the study and completed 6 months of esaxerenone therapy without any adverse events. eGFR decreased significantly during the pre-treatment period (from 66.6 to 59.5 mL/min/1.73 m; P=0.003), whereas eGFR was unchanged during the treatment period (from 59.5 to 61.8 mL/min/1.73 m; P=0.15). The median change in eGFR differed significantly between the treatment and pre-treatment periods (3.8 [IQR -4.2, 6.8] vs. -6.1 [IQR -11.1, 1.8] mL/min/1.73 m, respectively; P=0.008). Esaxerenone may have renoprotective effects when administered to treat hypertension. Further studies are needed to understand which patient populations may see greater renoprotective benefits with esaxerenone.
包括新推出的依普利酮在内的盐皮质激素受体拮抗剂对肾功能的影响仍不确定。本回顾性研究针对2019年11月至2020年6月期间接受依普利酮治疗顽固性高血压的患者进行。比较了依普利酮治疗前6个月（治疗前期）和依普利酮治疗6个月期间的估计肾小球滤过率（eGFR）趋势。26例患者（15例男性）纳入研究，中位年龄70岁（四分位间距[IQR]51 - 73岁），中位收缩压146 mmHg（IQR 139 - 156 mmHg），完成了6个月的依普利酮治疗且无任何不良事件。治疗前期eGFR显著下降（从66.6降至59.5 mL/min/1.73 m²；P = 0.003），而治疗期间eGFR无变化（从59.5升至61.8 mL/min/1.73 m²；P = 0.15）。治疗期和治疗前期eGFR的中位变化差异显著（分别为3.8[IQR -4.2, 6.8]与 -6.1[IQR -11.1, 1.8]mL/min/1.73 m²；P = 0.008）。依普利酮用于治疗高血压时可能具有肾脏保护作用。需要进一步研究以了解哪些患者群体使用依普利酮可能获得更大的肾脏保护益处。
