Delanaye Pierre, De Seigneux Sophie
Service de néphrologie, dialyse et transplantation, CHU Sart-Tilman, 4000 Liège, Belgique.
Service de néphrologie-dialyse-aphérèse, Hôpital universitaire Carémeau, Place du Professeur-Debré, 30029 Nîmes, France.
Rev Med Suisse. 2022 Aug 24;18(792):1534-1538. doi: 10.53738/REVMED.2022.18.792.1534.
Finerenone is a new mineralocorticoid receptor antagonist with a different structure, volume of distribution and half-life compared to spironolactone. This drug has been tested in two large, randomized trials including diabetic patients with chronic kidney disease (in terms of glomerular filtration rate and albuminuria) and already treated by renin-angiotensin system blockade. Results are positive on hard renal- and cardiac endpoints. Risk of hyperkalaemia is higher than with placebo but is considered as acceptable. An open question that will be tested in further studies is the role of finerenone in the context of a treatment by gliflozins, drugs that also showed cardiorenal protection.
非奈利酮是一种新型盐皮质激素受体拮抗剂，与螺内酯相比，其结构、分布容积和半衰期有所不同。该药物已在两项大型随机试验中进行了测试，试验对象为患有慢性肾病（根据肾小球滤过率和蛋白尿）且已接受肾素-血管紧张素系统阻断治疗的糖尿病患者。在肾脏和心脏硬终点方面结果呈阳性。高钾血症的风险高于安慰剂组，但被认为是可接受的。非奈利酮在使用格列净类药物治疗（这类药物也显示出心肾保护作用）的背景下所起的作用，这一开放性问题将在进一步研究中进行测试。
