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Nonsteroidal mineralcorticoid receptor antagonist finerenone: a new approach for drug therapy of chronic kidney disease
https://doi.org/10.36485/1561-6274-2024-28-3-9-18
EDN: PTAFNT
Abstract
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.
About the Authors
O. B. Kuzmin
Orenburg State Medical University
Russian Federation
Russian Federation
Prof. Oleg B. Kuzmin MD, PhD, DMedSci, Department of Pharmacology
460000, Orenburg, Park. av., 7
Phone: +7(919)8487669
V. V. Belyanin
Orenburg State Medical University
Russian Federation
Russian Federation
Associate professor Vitaliy V. Belyanin MD, PhD, Department of Pharmacology
460000, Orenburg, Park. av., 7
Phone: +7(912)8442604
N. V. Buchneva
Orenburg State Medical University
Russian Federation
Russian Federation
Associate professor Nataliya V. Buchneva MD, PhD, Department of Pharmacology
460000, Orenburg, Park. av., 7
Phone: +7(987)8703415
L. N. Landar
Orenburg State Medical University
Russian Federation
Russian Federation
Associate professor Larisa N. Landar MD PhD, Department of Pharmacology
460000, Orenburg, Park. av., 7
Phone: +7(915)0385128
S. V. Serdyuk
Orenburg State Medical University
Russian Federation
Russian Federation
Associate professor Svetlana V. Serdyuk MD, PhD, Department of Pharmacology
460000, Orenburg, Park. av., 7
Phone: +7(912)8414098
M. V. Stolbova
Orenburg State Medical University
Russian Federation
Russian Federation
Associate professor Marina V. Stolbova, MD, PhD, Department of Pharmacology
460000, Orenburg, Park. av., 7
Phone: +7 (905)8198191
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Review
For citations:
Kuzmin O.B., Belyanin V.V., Buchneva N.V., Landar L.N., Serdyuk S.V., Stolbova M.V. Nonsteroidal mineralcorticoid receptor antagonist finerenone: a new approach for drug therapy of chronic kidney disease. Nephrology (Saint-Petersburg). 2024;28(3):9-18. (In Russ.) https://doi.org/10.36485/1561-6274-2024-28-3-9-18. EDN: PTAFNT
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