nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2024-28-3-9-18PTAFNTnefr-2330Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESНестероидный антагонист минералкортикоидных рецепторов финеренон: новый подход к лекарственной терапии хронической болезни почекNonsteroidal mineralcorticoid receptor antagonist finerenone: a new approach for drug therapy of chronic kidney diseasehttps://orcid.org/0000-0003-3730-3665КузьминО. Б.KuzminO. B.

Проф. Кузьмин Олег Борисович, д-р мед. наук, кафедра фармакологии

460000, г. Оренбург, Парковый пр., д. 7

Тел.: +7(919)8487669

Prof. Oleg B. Kuzmin MD, PhD, DMedSci, Department of Pharmacology

460000, Orenburg, Park. av., 7

Phone: +7(919)8487669

kuzmin.orgma@mail.ruhttps://orcid.org/0000-0002-1981-179XБелянинВ. В.BelyaninV. V.

Доц. Белянин Виталий Васильевич, канд. мед. наук, кафедра фармакологии

460000, г. Оренбург, Парковый пр., д. 7

Тел.: +7(912)8442604

Associate professor Vitaliy V. Belyanin MD, PhD, Department of Pharmacology

460000, Orenburg, Park. av., 7

Phone: +7(912)8442604

vitbelya@yandex.ruhttps://orcid.org/0000-0002-4431-9641БучневаН. В.BuchnevaN. V.

Доц. Бучнева Наталья Викторовна, канд. мед. наук, кафедра фармакологии

460000, г. Оренбург, Парковый пр., д. 7

Тел.: +7(987)8703415

Associate professor Nataliya V. Buchneva MD, PhD, Department of Pharmacology

460000, Orenburg, Park. av., 7

Phone: +7(987)8703415

buzap@yandex.ruhttps://orcid.org/0000-0001-5021-5964ЛандарьЛ. Н.LandarL. N.

Доц. Ландарь Лариса Николаевна, канд. мед. наук, кафедра фармакологии

460000, г. Оренбург, Парковый пр., д. 7

Тел.: +7(951)0385128

Associate professor Larisa N. Landar MD PhD, Department of Pharmacology

460000, Orenburg, Park. av., 7

Phone: +7(915)0385128

landar@mail.ruhttps://orcid.org/0000-0003-4864-5513СердюкС. В.SerdyukS. V.

Доц. Сердюк Светлана Владимировна, канд. мед. наук, кафедра фармакологии

460000, г. Оренбург, Парковый пр., д. 7

Тел.: +7(912)8414098

Associate professor Svetlana V. Serdyuk MD, PhD, Department of Pharmacology

460000, Orenburg, Park. av., 7

Phone: +7(912)8414098

chubsvet@mail.ruhttps://orcid.org/0000-0002-7536-0209СтолбоваМ. В.StolbovaM. V.

Доц. Столбова Марина Владимировна, канд. мед. наук, кафедра фармакологии, заведующая кафедрой

460000, г. Оренбург, Парковый пр., д. 7

Тел.: +7 (905)8198191

Associate professor Marina V. Stolbova, MD, PhD, Department of Pharmacology

460000, Orenburg, Park. av., 7

Phone: +7 (905)8198191

stolbovam@yandex.ruОренбургский государственный медицинский университетРоссияOrenburg State Medical UniversityRussian Federation202417092024283918Copyright © Кузьмин О.Б., Белянин В.В., Бучнева Н.В., Ландарь Л.Н., Сердюк С.В., Столбова М.В., 20242024Кузьмин О.Б., Белянин В.В., Бучнева Н.В., Ландарь Л.Н., Сердюк С.В., Столбова М.В.Kuzmin O.B., Belyanin V.V., Buchneva N.V., Landar L.N., Serdyuk S.V., Stolbova M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/2330

Гормональная система альдостеронсинтаза–альдостерон–минералкортикоидный рецептор играет ключевую роль в повреждении почек, прогрессировании ХБП и повышении АД у пациентов с диабетической и недиабетической нефропатией. Стероидный антагонист минералкортикоидных (МК) рецепторов спиронолактон и заменяющий его эплеренон рекомендуется включать в комбинацию с ингибиторами РАС для контроля АД и снижения потери белка с мочой гипертензивным пациентам с С1–С3а стадиями ХБП. Однако использование этих препаратов при ХБП, особенно в сочетании с ингибиторами РАС, ограничено из-за риска развития гиперкалиемии, гинекомастии и других нежелательных побочных эффектов. В последнее время ведется разработка нового поколения антагонистов МК-рецепторов, которые отличаются от своих предшественников иным механизмом действия, улучшенными фармакологическим свойствами и более благоприятным профилем безопасности. В обзоре представлены данные об особенностях фармакокинетики и фармакодинамики нового нестероидного антагониста МК-рецепторов финеренона, а также результаты клинических исследований, полученные при оценке его эффективности и безопасности применения у пациентов с ХБП диабетического и недиабетического происхождения.

The hormonal system aldosterone synthase-aldosterone-mineralcorticoid receptor plays a key role in kidney damage, progression of CKD and increased blood pressure in patients with diabetic and nondiabetic nephropathy. The steroid antagonist of mineralcorticoid (MC) receptors spironolactone and its replacement eplerenone are recommended to be included in combination with RAS inhibitors to control blood pressure and reduce urinary protein loss in hypertensive patients with stages C1-C3a of CKD. However, the use this drugs in CKD is limited due to the risk of hyperkalemia, gynecomastia and other unwanted side effects. Recently, a new generation of MC receptor antagonists has been developed, which differ from its predecessors in a different mechanism of action, improved pharmacological properties and a more favorable safety profile. The review presents data on the pharmacokinetics and pharmacodynamics of the new nonsteroidal MC receptor antagonist finerenone, as well as the results of clinical studies obtained in assessing its effectiveness and safety in patients with CKD diabetic and nondiabetic origin.

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The authors declare that there are no conflicts of interest present.