Alhomoud Ibrahim S, Albekery Mohamed A, Alqadi Razan, Alqumia Amal, Khan Riaz A, Al Sahlawi Muthana, Al Mulhim Mohammed Yousef
Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim, Saudi Arabia.
Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia.
Front Med (Lausanne). 2025 Jun 2;12:1580645. doi: 10.3389/fmed.2025.1580645. eCollection 2025.
Diabetic kidney disease (DKD) represents a substantial health burden for patients with type 2 diabetes mellitus (T2DM), markedly increasing morbidity and mortality. The cornerstone of DKD treatment remains renin-angiotensin system (RAS) blockade and risk factor control, such as blood pressure management, glycemic control, albuminuria reduction, and lipid management. However, treatment strategies have expanded to include sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists, which have proven effective in slowing kidney disease progression when combined with RAS inhibitors. Finerenone, a non-steroidal mineralocorticoid receptor antagonist (MRA), represents a novel approach to the management of DKD. It offers unique pharmacokinetic and pharmacodynamic properties compared with steroidal MRAs such as spironolactone and eplerenone. This review addresses the evolving landscape of diabetic kidney disease management, with a focus on finerenone's distinct pharmacologic properties, structural characteristics, and clinical implications.
糖尿病肾病（DKD）给2型糖尿病（T2DM）患者带来了沉重的健康负担，显著增加了发病率和死亡率。DKD治疗的基石仍然是肾素-血管紧张素系统（RAS）阻断和危险因素控制，如血压管理、血糖控制、蛋白尿减少和血脂管理。然而，治疗策略已扩展到包括钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂和胰高血糖素样肽-1（GLP-1）受体激动剂，事实证明，与RAS抑制剂联合使用时，它们在减缓肾病进展方面有效。非甾体类盐皮质激素受体拮抗剂（MRA）非奈利酮是一种治疗DKD的新方法。与螺内酯和依普利酮等甾体类MRA相比，它具有独特的药代动力学和药效学特性。本综述阐述了糖尿病肾病管理的发展态势，重点关注非奈利酮独特的药理特性、结构特征和临床意义。
