The Ascent of Mineralocorticoid Receptor Antagonists in Diabetic Nephropathy.

The Ascent of Mineralocorticoid Receptor Antagonists in Diabetic Nephropathy. Curr Clin Pharmacol. 2018 Nov 15;: Authors: Goenka L, Padmanaban R, George M Abstract Diabetic nephropathy (DN) is defined as a decline in the renal function and an increase in the amount of albuminuria (>300 mg/day). The well-established first-line drug therapies for DN include angiotensin-converting enzyme inhibitor (ACEi) and angiotensin receptor blockers (ARBs) and the second line drug therapies include calcium channel blockers or diuretics. The interruption of the renin-angiotensin-aldosterone system (RAAS) by ACEi and ARBs has been beneficial in reducing the progression of renal diseases; however, there is an increase in the levels of aldosterone due to the aldosterone escape phenomenon. Newer and novel approaches to counteract this aldosterone breakthrough while accentuating the anti-hypertensive and anti-proteinuric effects of these agents would be ideal and mineralocorticoid receptor antagonists (MRAs) fit in this slot perfectly. This review attempted to evaluate the safety and efficacy of MRAs for DN. Presently MRAs such as spironolactone, eplerenone and finerenone are being investigated as both monotherapies and as an additional therapy. Clinical studies have shown that these drugs have been effective in the reduction of blood pressure (BP), urinary-albumin-excretion (UAE) and estimated glomerular filtration rate (eGFR). The adverse effects of...
Source: Current Clinical Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Curr Clin Pharmacol Source Type: research