FINERENONE: A BREAKTHROUGH IN THE MANAGEMENT OF DIABETIC KIDNEY DISEASE

Sandhra R. Nair*, Lathika A. Nayak and A. R. Shabharaya

ABSTRACT

Nonsteroidal mineralocorticoid receptor antagonists (MRAs) offer a promising therapeutic alternative in cardiorenal diseases, addressing the shortcomings of steroidal MRAs. A non-steroidal selective MRA, finerenone shows promise in halting the decline of renal function in chronic kidney disease (CKD) with diabetes mellitus (DM), lowering albuminuria and lowering hyperkalemia, and improving cardiovascular outcomes by lowering heart failure episodes. The effectiveness of finerenone in enhancing kidney and cardiovascular (CV) outcomes was demonstrated by clinical trials, such as FIDELIO-DKD and FIGARO-DKD. On finerenone, patients with type 2 diabetes (T2DM) and chronic kidney disease (CKD) had lower rates of cardiovascular events, such as heart attack hospitalization. However, these trials focused on asymptomatic or early-stage HF and excluded patients with symptoms.In addition to offering insights into the present and future of cardiorenal disease management, this review attempts to provide a thorough overview of the mechanisms and clinical evaluation of nonsteroidal MRA finerenone. Clinical trials of finerenone in patients with nondiabetic kidney disease are still underway, but the evidence supporting its beneficial effect in the range of cardiorenal diseases is currently limited to the findings of studies done on T2DM patients. Nonsteroidal MRAs have a great deal of promise as key therapeutic targets for a variety of heart conditions.

Keywords: finerenone, diabetic kidney disease, cardiorenal disease, mineralocorticoid receptor antagonist, heart failure.