Affiliation:
1. Drake University College of Pharmacy and Health Sciences Des Moines IA 50311 USA
2. Reagents and Assay Development R&D BD Biosciences San Jose CA 95131 USA
3. Department of Pharmaceutical and Administrative Sciences Drake University College of Pharmacy and Health Sciences Des Moines IA 50311 USA
Abstract
AbstractDiabetic kidney disease (DKD) is a growing epidemic worldwide and a leading cause of end‐stage kidney disease. Mineralocorticoid receptor (MR) blockade using Finerenone is a recently approved therapeutic approach to slow down the progression of DKD in patients with type 2 diabetes in addition to other therapies such as angiotensin‐II converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), sodium‐glucose co‐transporter 2 (SGLT2) inhibitors, and glucagon‐like peptide 1 (GLP‐1) analogs. This review elaborates on the pathophysiologic pathways activated by aldosterone (the human mineralocorticoid) in DKD, the pharmacology of three different generations of mineralocorticoid receptor antagonists (MRAs), specifically, spironolactone, eplerenone, and finerenone, and the mechanisms by which these MRAs elicit their protective effects on the kidney under diabetic settings.
Funder
Drake Undergraduate Science Collaborative Institute