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Finerenone in the treatment of chronic kidney disease and type 2 diabetes mellitus and case report


Authors: Tímea Blichová 1,2;  Patrícia Kleinová 1,2;  Matej Vnučák 1,2;  Karol Graňák 1,2;  Monika Beliančinová 1,2;  Ivana Dedinská 1,2
Authors‘ workplace: I. interná klinika JLF UK a UNM, Martin 1;  Transplantačno-nefrologické oddelenie UNM, Martin 2
Published in: Forum Diab 2024; 13(2): 62-66
Category: Review Article

Overview

Diabetes mellitus is the most common cause of chronic kidney disease (CKD), which progressively leads to end-stage renal failure with the need for renal replacement. Patients with type 2 diabetes mellitus (T2DM) are at higher risk of cardiovascular events (myocardial infarction, stroke, arrhythmias and heart failure] and progression to chronic kidney disease. The aim is to prevent these complications by lifestyle changes, regular monitoring of blood pressure and glycemic levels, as well as the use of cardioprotective and nephroprotective drugs. Finerenone, as a non-steroidal selective mineralocorticoid receptor antagonist, represents, together with angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARBs) and sodium-glucose cotransporter 2 inhibitors (SGLT2i), the mainstay of treatment in patients with T2DM and CKD to prevent the progression of chronic kidney disease and prevent cardiovascular events. This article provides more information on the mechanism of action of finerenone, the results of the finerenone trials (FIDELIO-DKD and FIGARO-DKD), and the indication criteria that are valid in Slovakia and must be met before finerenone can be added to the treatment regimen. Finally, we present a short case report of our patient showing the effect of finerenone treatment in practice.

Keywords:

diabetes mellitus – chronic kidney disease (CKD) – finerenone – mineralocorticoid receptor antagonist


Sources

Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int 2024; 105(4S): 117–314. Dostupné z DOI: <https://doi: 10.1016/j.kint.2023.10.018>.

National Kidney Foundation. Chronic Kidney Disease. Dostupné z DOI: <https://www.kidney.org/atoz/content/about-chronic-kidney-disease>.

U.S. Centres for Disease Control and Prevention. Chronic Kidney Disease in the United States, 2023. Dostupné z WWW: <https://www.cdc.gov/kidneydisease/publications-resources/ckd-national-facts.html>.

NIH. Diabetic Kidney Disease. Dostupné z WWW: <https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-kidney-disease>.

IDF. IDF Diabetes Atlas. Dostupné z WWW: <https://https://diabetesatlas.org/data/en/world>.

NCZI. Na Slovensku je sledovaných 349 595 pacientov s cukrovkou. Dostupné z WWW: <https://www.nczisk.sk/Documents/aktuality/tlacove_spravy/2023/TS_NCZI_Na_Slovensku_je_sledovanych_349595_pacientov_cukrovkou_14112023.pdf>.

NCZI. Nefrológia. Dostupné z WWW: <https://www.nczisk.sk/Statisticke_vystupy/Tematicke_statisticke_vystupy/Nefrologia/Pages/default.aspx>.

DeFronzo RA, Reeves WB, Awad AS. Pathophysiology of diabetic kidney disease: impact of SGLT2 inhibitors. Nat Rev Nephrol 2021; 17(5): 319–334. Dostupné z DOI: <https://doi: 10.1038/s41581–021–00393–8>.

Agarwal R, Filippatos G, Pitt B et al. Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis. Eur Heart J 2022; 43(6): 474–484. Dostupné z DOI: <https://doi: 10.1093/eurheartj/ehab777>.

Perkovic V, Badve SV, Bakris GL. Treatment of diabetic kidney disease. Uptodate 2022. Dostupné z WWW: <https://pro.uptodatefree.ir/Show/3052>.

National Institute of Diabetes and Digestive and Kidney Diseases. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Finerenone. NIDDK 2023. Dostupné z WWW: <https://www.ncbi.nlm.nih.gov/books/NBK597221>.

Epstein M. Aldosterone and Mineralocorticoid Receptor Signaling as Determinants of Cardiovascular and Renal Injury: From Hans Selye to the Present. Am J Nephrol 2021; 52(3): 209–216. Dostupné z DOI: <https://doi: 10.1159/000515622>.

Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney Int 2022; 102(5S): 1–127. Dostupné z DOI: <https://doi: 10.1016/j.kint.2022.06.008>.

Marx N, Federici M, Schütt K et al. 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes: Developed by the task force on the management of cardiovascular disease in patients with diabetes of the European Society of Cardiology (ESC). Eur Heart J 2023; 44(39): 4043–4140. Dostupné z DOI: <https://doi: 10.1093/eurheartj/ehad192>.

SPC Kerendia. Dostupné z WWW: <https://www.ema.europa.eu/sk/documents/overview/kerendia-epar-medicine-overview_sk.pdf>.

Labels
Diabetology Endocrinology Internal medicine
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