diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM13222diaendo-13222Research ArticleОбзорыReviewНовая эра кардионефропротекции у больных с сахарным диабетом 2 типа: как использовать возможности терапии препаратом финеренонA new era of cardiac nephroprotection in patients with type 2 diabetes mellitus: the role of Finerenonehttps://orcid.org/0000-0002-7755-7275ХалимовЮ. Ш.KhalimovI. S.

Халимов Юрий Шавкатович - д.м.н., профессор.

Санкт-Петербург

Iurii S. Khalimov - MD, PhD, Professor.

Saint Petersburg

yushkha@gmail.comhttps://orcid.org/0000-0002-3231-6152ПоляковаЕ. А.PolyakovaE. A.

Полякова Екатерина Анатольевна - д.м.н., профессор.

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8

Ekaterina A. Polyakova, MD, PhD, Professor.

6-8 L. Tolstoy street, 197022 Saint Petersburg

polyakova_ea@yahoo.comhttps://orcid.org/0009-0009-1817-0255ШутоваЮ. А.ShutovaYu. A.

Шутова Юлия Александровна

Санкт-Петербург

Yulia A. Shutova

Saint Petersburg

yulia_gladkaya.w@mail.ruПервый Санкт-Петербургский государственный медицинский университет им. академика И.П. ПавловаРоссияPavlov First Saint Petersburg State Medical UniversityRussian FederationАО «БАЙЕР»РоссияJSC BayerRussian Federation202418012025276620628Copyright © Халимов Ю.Ш., Полякова Е.А., Шутова Ю.А., 20252025Халимов Ю.Ш., Полякова Е.А., Шутова Ю.А.Khalimov I.S., Polyakova E.A., Shutova Y.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/13222

Основной задачей современного здравоохранения является повышение продолжительности и качества жизни пациентов, особенно с социально значимыми заболеваниями, такими как сахарный диабет 2 типа (СД2) и его осложнения. Хроническая болезнь почек (ХБП) — одно из наиболее частых осложнений СД2, которым страдают свыше 160 млн человек и является независимым фактором риска сердечно-сосудистых (СС) осложнений, терминальной стадии почечной недостаточности, требующей проведения гемодиализа или трансплантации почек. Эффективное управление кардиоренальными рисками и осложнениями СД2 с помощью назначения пациентам блокаторов ренин-ангиотензин-альдостероновой системы и ингибиторов натрий-глюкозного котранспортера 2 типа дополнилось в 2023 г. новым селективным нестероидным антагонистом минералокортикоидных рецепторов — финереноном. Этот единственный в своем классе препарат позволяет значительно улучшить управляемость процессами воспаления, фиброза в почках и ремоделирования миокарда. В данной публикации представлены эффекты финеренона в отношении темпов ежегодного снижения расчетной скорости клубочковой фильтрации как основного показателя функции почек, а также предложены практические рекомендации по обеспечению безопасной инициации тройной кардионефропротективной терапии ХБП при СД2 в соответствии с действующими клиническими рекомендациями.

The main factor in modern healthcare is to increase the length and quality of life of patients, especially with socially significant diseases, such as type 2 diabetes mellitus (T2DM) and its dangerous complication — chronic kidney disease (CKD), associated with a high rate of cardiovascular diseases (CVD), end-stage renal disease and mortality. Effective management of cardiorenal risks in addition with blockers of the renin-angiotensin-aldosterone system and sodium-glucose cotransporter type 2 inhibitors was replenished in 2023 with a new non-steroidal selective mineralocorticoid receptor antagonist — Finerenone. This unique and one-of-a-kind drug improves the control of cellular processes, fibrosis in the kidneys and myocardial remodeling. This review presents the main studies on the mechanism of action of Finerenone, assessment of its effectiveness and safety, and its effect on the risk of developing cardiorenal risk in patients with T2DM. Finerenone is one-of-a-kind drug who has no alternatives to improve a control of cellular processes, a fibrosis in the kidneys and a myocardial remodeling. In this review we presented Finerenone effects on an eGFR slope as a main kidney function feature, and proposed practice points on safe initiation of the three cardiorenal «pillars» in patients with T2DM in accordance with the current clinical guidelines.

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The authors declare that there are no conflicts of interest present.