The mineralocorticoid receptor in chronic kidney disease
Chronic kidney disease (CKD) is a major public health concern, affecting approximately 10% of the population worldwide. CKD of glomerular or tubular origin leads to the activation of stress mechanisms, including the renin–angiotensin–aldosterone system and mineralocorticoid receptor (MR) activation....
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Published in | British journal of pharmacology Vol. 179; no. 13; pp. 3152 - 3164 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
England
Blackwell Publishing Ltd
01.07.2022
Wiley |
Subjects | |
Online Access | Get full text |
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Summary: | Chronic kidney disease (CKD) is a major public health concern, affecting approximately 10% of the population worldwide. CKD of glomerular or tubular origin leads to the activation of stress mechanisms, including the renin–angiotensin–aldosterone system and mineralocorticoid receptor (MR) activation. Over the last two decades, blockade of the MR has arisen as a potential therapeutic approach against various forms of kidney disease. In this review, we summarize the experimental studies that have shown a protective effect of MR antagonists (MRAs) in nondiabetic and diabetic CKD animal models. Moreover, we review the main clinical trials that have shown the clinical application of MRAs to reduce albuminuria and, importantly, to slow CKD progression. Recent evidence from the FIDELIO trial showed that the MRA finerenone can reduce hard kidney outcomes when added to the standard of care in CKD associated with type 2 diabetes. Finally, we discuss the effects of MRAs relative to those of SGLT2 inhibitors, as well as the potential benefit of combination therapy to maximize organ protection.
LINKED ARTICLES
This article is part of a themed issue on Emerging Fields for Therapeutic Targeting of the Aldosterone‐Mineralocorticoid Receptor Signaling Pathway. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v179.13/issuetoc |
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Bibliography: | Funding information Frédéric Jaisser and Hans‐Joachim Anders shared senior authorship. Fondation de France, Grant/Award Number: CARDIO 00086498; Fondation de Recherche sur l’Hypertension Artérielle, Grant/Award Number: REIN/NgalPA ‐ 2017/2018; Deutsche Forschungsgemeinschaft, Grant/Award Number: AN372/30‐1; Agence Nationale de la Recherche, Grant/Award Number: ANR‐19‐CE14‐0013 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1 |
ISSN: | 0007-1188 1476-5381 |
DOI: | 10.1111/bph.15734 |