A new era of cardiac nephroprotection in patients with type 2 diabetes mellitus: the role of Finerenone

I. S. Khalimov; E. A. Polyakova; Yu. A. Shutova

doi:10.14341/DM13222

A new era of cardiac nephroprotection in patients with type 2 diabetes mellitus: the role of Finerenone

I. S. Khalimov, E. A. Polyakova, Yu. A. Shutova

https://doi.org/10.14341/DM13222

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Abstract

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.

Keywords

diabetes mellitus, сhronic kidney disease, eGFR slope, finerenone

About the Authors

I. S. Khalimov

Pavlov First Saint Petersburg State Medical University
Russian Federation

Iurii S. Khalimov - MD, PhD, Professor.

Saint Petersburg

Competing Interests:

Публикация подготовлена при поддержке АО «Байер». Компания «Байер» поддерживала техническую редакцию статьи

E. A. Polyakova

Pavlov First Saint Petersburg State Medical University
Russian Federation

Ekaterina A. Polyakova, MD, PhD, Professor.

6-8 L. Tolstoy street, 197022 Saint Petersburg

Competing Interests:

Yu. A. Shutova

JSC Bayer
Russian Federation

Yulia A. Shutova

Saint Petersburg

Competing Interests:

является сотрудником АО «Байер»

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Supplementary files

	1. Figure 1. Possible trajectories of chronic kidney disease progression.
	Subject
	Type	Исследовательские инструменты
	View (222KB)	Indexing metadata ▾

	2. Figure 2. Kidney function depending on the number of remaining functional nephrons. Adapted from Tonneijck L et al. [12].
	Subject
	Type	Исследовательские инструменты
	View (449KB)	Indexing metadata ▾

	3. Figure 3. Long-term effects of finerenone therapy on slowing the decline in estimated glomerular filtration rate. Adapted from Bakris GL et al. [30].
	Subject
	Type	Исследовательские инструменты
	View (638KB)	Indexing metadata ▾

	4. Figure 4. Potential of combined therapy with finerenone and sodium-glucose co-transporter-2 inhibitors in patients with chronic kidney disease and type 2 diabetes mellitus to slow the decline in estimated glomerular filtration rate. The presented graph is based on the extrapolation of the rates of decline in estimated glomerular filtration rate observed over 3 years in patients with chronic kidney disease and type 2 diabetes mellitus from the FIDELITY subgroup [35].
	Subject
	Type	Исследовательские инструменты
	View (615KB)	Indexing metadata ▾

Review

For citations:

Khalimov I.S., Polyakova E.A., Shutova Yu.A. A new era of cardiac nephroprotection in patients with type 2 diabetes mellitus: the role of Finerenone. Diabetes mellitus. 2024;27(6):620-628. (In Russ.) https://doi.org/10.14341/DM13222

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).

ISSN 2072-0351 (Print)
ISSN 2072-0378 (Online)

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	Title	Figure 1. Possible trajectories of chronic kidney disease progression.
	Type	Исследовательские инструменты
	Date	2025-02-20
Digital Object Identifier	https://doi.org/10.14341/DM13222-7379

	Title	Figure 2. Kidney function depending on the number of remaining functional nephrons. Adapted from Tonneijck L et al. [12].
	Type	Исследовательские инструменты
	Date	2025-02-20
Digital Object Identifier	https://doi.org/10.14341/DM13222-7380

	Title	Figure 3. Long-term effects of finerenone therapy on slowing the decline in estimated glomerular filtration rate. Adapted from Bakris GL et al. [30].
	Type	Исследовательские инструменты
	Date	2025-02-20
Digital Object Identifier	https://doi.org/10.14341/DM13222-7381

	Title	Figure 4. Potential of combined therapy with finerenone and sodium-glucose co-transporter-2 inhibitors in patients with chronic kidney disease and type 2 diabetes mellitus to slow the decline in estimated glomerular filtration rate. The presented graph is based on the extrapolation of the rates of decline in estimated glomerular filtration rate observed over 3 years in patients with chronic kidney disease and type 2 diabetes mellitus from the FIDELITY subgroup [35].
	Type	Исследовательские инструменты
	Date	2025-02-20
Digital Object Identifier	https://doi.org/10.14341/DM13222-7382

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Diabetes mellitus

A new era of cardiac nephroprotection in patients with type 2 diabetes mellitus: the role of Finerenone

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Abstract

Keywords

About the Authors

References

Supplementary files

Review

For citations:

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