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Research progress on the cardiorenal protection of non-steroid mineralocorticoid receptor antagonists in patients with chronic kidney disease

LIU Wen-Yu, YU Sheng-Qiang^*

Department of Nephrology, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China

Abstract

Mineralocorticoid receptor antagonists not only are used as a diuretics to treat essential hypertension, but also protect the heart and kidney by inhibiting inflammation and fibrosis. Since the discovery of spironolactone, the first generation of mineralocorticoid receptor antagonist, two types of non-steroid mineralocorticoid receptor antagonists (finerenone and esaxerenone) approved for clinical use have been developed, which have the advantages of high affinity, high selectivity and balanced distribution in heart and kidney, and can be used in clinic as a cardiorenal protective drug. In this paper, the development history of mineralocorticoid receptor antagonists was reviewed, and the pathophysiological mechanism of inflammation and fibrosis caused by mineralocorticoid receptors and the similarities and differences of different generations of mineralocorticoid receptor antagonists were analyzed. In particular, the phase III clinical research evidence of finerenone and esaxerenone was discussed. This paper also reviews the research progress of cardiorenal protection of non-steroid mineralocorticoid receptor antagonists in patients with chronic kidney disease.

Key words: non-steroid mineralocorticoid receptor antagonists; type 2 diabetes; chronic kidney disease; cardiovascular disease

Received: 　　Accepted:

Corresponding author: 郁胜强　　E-mail: ysqdd1@126.com

Citing This Article：

LIU Wen-Yu, YU Sheng-Qiang. Research progress on the cardiorenal protection of non-steroid mineralocorticoid receptor antagonists in patients with chronic kidney disease. Acta Physiol Sin 2022; 74 (6): 1023-1030 (in Chinese with English abstract).