The role of a novel mineralocorticoid receptor antagonist, finerenone, in chronic kidney disease: mechanisms and clinical advances

Clin Exp Nephrol. 2024 Feb;28(2):125-135. doi: 10.1007/s10157-023-02413-2. Epub 2023 Oct 17.

Abstract

Background: Chronic kidney disease (CKD) poses a significant health risk in contemporary society. Current CKD treatments primarily involve renin-angiotensin-aldosterone system inhibitors and mineralocorticoid receptor antagonists, albeit associated with hyperkalemia risks. A novel selective mineralocorticoid receptor antagonist, finerenone, offers a promising, safer alternative for CKD therapy. This review comprehensively assesses the role and efficacy of finerenone in CKD treatment by analyzing clinical and animal studies. Emerging evidence consistently supports finerenone's ability to effectively slow the progression of CKD. By targeting the mineralocorticoid receptor, finerenone not only mitigates renal damage but also exhibits a favorable safety profile, minimizing hyperkalemia concerns.

Conclusion: Finerenone emerges as a valuable addition to CKD therapy, demonstrating potential benefits in delaying CKD progression while minimizing side effects. Nevertheless, further clinical trials are necessary to provide a comprehensive understanding of its safety and efficacy.

Keywords: Chronic kidney disease; Fibrosis; Finerenone; Inflammation; Mineralocorticoid receptor.

Publication types

  • Review

MeSH terms

  • Animals
  • Diabetes Mellitus, Type 2* / complications
  • Hyperkalemia* / chemically induced
  • Hyperkalemia* / drug therapy
  • Mineralocorticoid Receptor Antagonists / adverse effects
  • Naphthyridines / adverse effects
  • Renal Insufficiency, Chronic* / chemically induced
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / drug therapy

Substances

  • Mineralocorticoid Receptor Antagonists
  • finerenone
  • Naphthyridines