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Finerenone: a new mineralocorticoid receptor antagonist to beat chronic kidney disease


Raj, R, Finerenone: a new mineralocorticoid receptor antagonist to beat chronic kidney disease, Current Opinion in Nephrology and Hypertension, 31, (30) pp. 265-271. ISSN 1062-4821 (2022) [Refereed Article]

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Copyright 2022 Wolters Kluwer Health, Inc.

DOI: doi:10.1097/MNH.0000000000000785


Purpose of review: Clinical trials of the mineralocorticoid receptor antagonist (MRA) finerenone published recently suggest that they improve outcomes in patients with diabetic kidney disease (DKD). This review summarises key research from the last two years to provide clinicians with a synopsis of recent findings.

Recent findings Large international trials, such as Finerenone in Reducing Kidney Failure and Disease Progression in Diabetic Kidney Disease (5674 participants) and Finerenone in Reducing Cardiovascular Mortality and Morbidity in Diabetic Kidney Disease (7437 participants), suggest that in proteinuric patients with DKD and estimated glomerular filtration rate >25 ml/min/1.73 m2, already on renin-angiotensin-aldosterone system inhibitors, addition of finerenone provided modest further improvement in composite renal and cardiovascular outcomes. Proteinuria was reduced; there was also a small drop in systolic blood pressure. Hyperkalaemia remained a concern, although the incidence is lower with finerenone. Emerging data suggest that newer potassium binding agents may mitigate this risk. Preclinical studies suggest additive benefits when MRA and sodium-glucose co-transporter 2 (SGLT-2) inhibitors are used in combination.

Summary The nonsteroidal MRA finerenone could improve renal and cardiac outcomes further in diabetics with kidney disease when added to renin-angiotensin system inhibitors. Hyperkalaemia is probably less worrisome, but real-world data is needed. Combinations with other new nephroprotective agents (such as SGLT2i inhibitors) has the potential to provide increasing benefit. Benefits of finerenone in chronic kidney disease without diabetes remains to be seen.

Item Details

Item Type:Refereed Article
Keywords:aldosterone, diabetic kidney disease, finerenone, mineralocorticoid receptor antagonist
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Nephrology and urology
Objective Division:Health
Objective Group:Clinical health
Objective Field:Efficacy of medications
UTAS Author:Raj, R (Dr Rajesh Raj)
ID Code:149104
Year Published:2022
Deposited By:Medicine
Deposited On:2022-03-08
Last Modified:2022-09-13

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