Role of Mineralocorticoid Receptor Antagonists in Diabetic Kidney Disease

Diabetic kidney disease (DKD) represents a major public health issue, currently posing an important burden on healthcare systems. Renin–angiotensin system (RAS) blockers are considered the cornerstone of treatment albuminuric DKD. However, high residual risk progression to more advanced CKD stages under RAS blockade still remains, while relevant studies did not show significant declines in cardiovascular events with these agents patients Among several other pharmacological classes, mineralocorticoid receptor antagonists (MRAs) have received increasing interest, due growing body high-quality evidence showing that spironolactone and eplerenone can significantly lower blood pressure albuminuria CKD. Furthermore, finerenone, novel nonsteroidal MRA unique physicochemical properties, was shown effectively reduce death, as well incidence end-stage type 2 diabetes. This review discusses previous recent clinical issue nephroprotection cardioprotection DKD offered by antagonism, aiming aid clinicians their decisions for diabetic patients.