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新型盐皮质激素受体拮抗剂非奈利酮在慢性肾脏病中的作用:作用机制与临床进展

The role of a novel mineralocorticoid receptor antagonist, finerenone, in chronic kidney disease: mechanisms and clinical advances.

作者信息

Chen Xinping, Li Xuan, Zhang Kexin, Lian Kexin, Zhang Wenqiang, Song Yixin, Kan Chengxia, Zhang Jingwen, Han Fang, Sun Xiaodong, Guo Zhentao

机构信息

Department of Nephrology, Affiliated Hospital of Weifang Medical University, Weifang, 261031, China.

Clinical Research Center, Affiliated Hospital of Weifang Medical University, Weifang, 261031, China.

出版信息

Clin Exp Nephrol. 2024 Feb;28(2):125-135. doi: 10.1007/s10157-023-02413-2. Epub 2023 Oct 17.

Abstract

BACKGROUND

Chronic kidney disease (CKD) poses a significant health risk in contemporary society. Current CKD treatments primarily involve renin-angiotensin-aldosterone system inhibitors and mineralocorticoid receptor antagonists, albeit associated with hyperkalemia risks. A novel selective mineralocorticoid receptor antagonist, finerenone, offers a promising, safer alternative for CKD therapy. This review comprehensively assesses the role and efficacy of finerenone in CKD treatment by analyzing clinical and animal studies. Emerging evidence consistently supports finerenone's ability to effectively slow the progression of CKD. By targeting the mineralocorticoid receptor, finerenone not only mitigates renal damage but also exhibits a favorable safety profile, minimizing hyperkalemia concerns.

CONCLUSION

Finerenone emerges as a valuable addition to CKD therapy, demonstrating potential benefits in delaying CKD progression while minimizing side effects. Nevertheless, further clinical trials are necessary to provide a comprehensive understanding of its safety and efficacy.

摘要

背景

慢性肾脏病(CKD)在当代社会构成了重大的健康风险。目前CKD的治疗主要涉及肾素-血管紧张素-醛固酮系统抑制剂和盐皮质激素受体拮抗剂,尽管存在高钾血症风险。一种新型选择性盐皮质激素受体拮抗剂非奈利酮为CKD治疗提供了一种有前景、更安全的替代方案。本综述通过分析临床和动物研究全面评估非奈利酮在CKD治疗中的作用和疗效。新出现的证据一致支持非奈利酮有效延缓CKD进展的能力。通过靶向盐皮质激素受体,非奈利酮不仅减轻肾损伤,而且表现出良好的安全性,将高钾血症问题降至最低。

结论

非奈利酮成为CKD治疗中有价值的补充药物,在延缓CKD进展的同时将副作用降至最低,显示出潜在益处。然而,需要进一步的临床试验以全面了解其安全性和疗效。

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