目錄/各期文章

內科學誌 -第36卷第4期

綜論 
The Cardiorenal Protective Effects of Nonsteroidal Mineralocorticoid Receptor Antagonist (Finerenone) in Diabetic Kidney Disease  全文閱讀
221~245 
英文 
Finerenone、diabetic kidney disease、nonsteroidal mineralocorticoid receptor antagonists、cardiorenal protection、hyperkalemia;、sodium-glucose cotransporter-2 inhibitors 
曾國賓1,2  
義大癌治療醫院內科部內分泌暨新陳代謝科1 、義守大學醫學院2  
Diabetic kidney disease (DKD) affects nearly half of individuals with diabetes and is the leading cause of chronic kidney disease (CKD) globally. Traditionally, renin-angiotensin system (RAAS) inhibitors have been critical for DKD management. In recent years, sodium-glucose cotransporter-2 inhibitors (SGLT2is) have elicited promising renal outcomes in controlled clinical trials. Nevertheless, despite the combined use of RAAS inhibitors and SGLT2is, renal complications remain common, and these medications only delay kidney failure. In diabetes, mineralocorticoid receptor dysregulation exacerbates cardiovascular and renal pathologies. Steroidal mineralocorticoid receptor antagonists (MRAs) exert cardiorenal benefits in individuals with DKD but increase the risks of hyperkalemia and other adverse effects. Nonsteroidal MRAs have a distinct pharmacological profile that enables them to provide cardiorenal protection and minimize hyperkalemia risks in patients with CKD. These novel agents are being investigated for heart failure treatment and possible synergistic effects with SGLT2is, presenting a promising therapeutic avenue for various cardiorenal disorders. This study reviewed the evidence on the cardiorenal protective benefits of nonsteroidal MRA—finerenone, examining molecular mechanisms and exploring applications in treating patients with DKD. Additionally, this review explored the use of nonsteroidal MRAs in combination with SGLT2is or glucagon-like peptide-1 receptor agonists as a strategy to reduce the risk of DKD.