糖尿病肾病中的盐皮质激素受体拮抗剂
Mineralocorticoid Receptor Antagonists in Diabetic Kidney Disease.
作者信息
Vodošek Hojs Nina, Bevc Sebastjan, Ekart Robert, Piko Nejc, Petreski Tadej, Hojs Radovan
机构信息
Department of Nephrology, Clinic for Internal Medicine, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia.
Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia.
出版信息
Pharmaceuticals (Basel). 2021 Jun 11;14(6):561. doi: 10.3390/ph14060561.
Abstract
Diabetes mellitus is a global health issue and main cause of chronic kidney disease. Both diseases are also linked through high cardiovascular morbidity and mortality. Diabetic kidney disease (DKD) is present in up to 40% of diabetic patients; therefore, prevention and treatment of DKD are of utmost importance. Much research has been dedicated to the optimization of DKD treatment. In the last few years, mineralocorticoid receptor antagonists (MRA) have experienced a renaissance in this field with the development of non-steroidal MRA. Steroidal MRA have known cardiorenal benefits, but their use is limited by side effects, especially hyperkalemia. Non-steroidal MRA still block the damaging effects of mineralocorticoid receptor overactivation (extracellular fluid volume expansion, inflammation, fibrosis), but with fewer side effects (hormonal, hyperkalemia) than steroidal MRA. This review article summarizes the current knowledge and newer research conducted on MRA in DKD.
摘要
糖尿病是一个全球性的健康问题，也是慢性肾脏病的主要病因。这两种疾病还都与心血管疾病的高发病率和高死亡率相关。高达40%的糖尿病患者患有糖尿病肾病（DKD）；因此，DKD的预防和治疗至关重要。许多研究致力于优化DKD的治疗。在过去几年中，随着非甾体类盐皮质激素受体拮抗剂（MRA）的开发，MRA在该领域迎来了复兴。甾体类MRA具有已知的心脏和肾脏益处，但其使用受到副作用的限制，尤其是高钾血症。非甾体类MRA仍然可以阻断盐皮质激素受体过度激活的有害影响（细胞外液量扩张、炎症、纤维化），但副作用（激素、高钾血症）比甾体类MRA少。这篇综述文章总结了目前关于MRA在DKD方面的知识和最新研究。
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本文引用的文献
1
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Nat Commun. 2021 Apr 22;12(1):2368. doi: 10.1038/s41467-021-22617-y.
2
Aldosterone and Mineralocorticoid Receptor Signaling as Determinants of Cardiovascular and Renal Injury: From Hans Selye to the Present.醛固酮和盐皮质激素受体信号作为心血管和肾脏损伤的决定因素：从汉斯·塞利到现在。
Am J Nephrol. 2021;52(3):209-216. doi: 10.1159/000515622. Epub 2021 Apr 15.
3
Effect of linagliptin versus placebo on cardiovascular and kidney outcomes in nephrotic-range proteinuria and type 2 diabetes: the CARMELINA randomized controlled trial.利格列汀与安慰剂对肾病范围蛋白尿和2型糖尿病患者心血管及肾脏结局的影响：CARMELINA随机对照试验
Clin Kidney J. 2021 Jan 17;14(1):226-236. doi: 10.1093/ckj/sfaa225. eCollection 2021 Jan.
4
The mineralocorticoid receptor-an emerging player in metabolic syndrome?醛固酮受体——代谢综合征的新角色？
J Hum Hypertens. 2021 Feb;35(2):117-123. doi: 10.1038/s41371-020-00467-3. Epub 2021 Feb 1.
5
Antihypertensive effects and safety of esaxerenone in patients with moderate kidney dysfunction.伴有中度肾功能障碍患者用依斯巴伦诺的降压效果和安全性。
Hypertens Res. 2021 May;44(5):489-497. doi: 10.1038/s41440-020-00585-y. Epub 2020 Dec 16.
6
Investigating new treatment opportunities for patients with chronic kidney disease in type 2 diabetes: the role of finerenone.研究 2 型糖尿病慢性肾脏病患者的新治疗机会：非奈利酮的作用。
Nephrol Dial Transplant. 2022 May 25;37(6):1014-1023. doi: 10.1093/ndt/gfaa294.
7
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N Engl J Med. 2020 Dec 3;383(23):2219-2229. doi: 10.1056/NEJMoa2025845. Epub 2020 Oct 23.
8
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Clin J Am Soc Nephrol. 2020 Dec 7;15(12):1715-1727. doi: 10.2215/CJN.06870520. Epub 2020 Nov 25.
9
Effect of sodium-glucose cotransporter 2 inhibitors on cardiovascular and kidney outcomes-Systematic review and meta-analysis of randomized placebo-controlled trials.钠-葡萄糖共转运蛋白 2 抑制剂对心血管和肾脏结局的影响——随机安慰剂对照试验的系统评价和荟萃分析。
Am Heart J. 2021 Feb;232:10-22. doi: 10.1016/j.ahj.2020.10.064. Epub 2020 Oct 24.
10
Finerenone and Cardiovascular Outcomes in Patients With Chronic Kidney Disease and Type 2 Diabetes.非奈利酮与慢性肾脏病合并 2 型糖尿病患者的心血管结局。
Circulation. 2021 Feb 9;143(6):540-552. doi: 10.1161/CIRCULATIONAHA.120.051898. Epub 2020 Nov 16.
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