Scientific article
Open access

Mineralocorticoid receptor antagonists in patients with chronic kidney disease

Published inPharmacology & Therapeutics, vol. 219, 107701
Publication date2021

Mineralocorticoid receptor antagonists (MRA) can reduce cardiovascular morbidity and mortality in patients with heart failure and ischemic heart disease. In addition, these agents have been used in patients with diabetic nephropathy to control proteinuria and slow down chronic kidney disease (CKD) progression. Current guidelines recommend against the use of MRAs in patients with advanced CKD. However, there is growing interest on their use in this population that has unmet needs (high cardiovascular morbidity and mortality) and unique challenges (risk of acute kidney injury or hyperkalemia). This narrative review discusses the emerging role of MRAs for the management of cardiovascular disease and/or the prevention of CKD progression, highlighting results from randomized controlled trials and presenting real-world data from available registries. Results from recent trials in patients on maintenance dialysis are also discussed.

  • Mineralocorticoid receptor antagonist
  • Chronic kidney disease
  • Congestive heart failure
  • Diabetic nephropathy
  • End-Stage renal disease
  • Chronic kidney disease progression
Citation (ISO format)
COSIMATO, Cosimo, AGORITSAS, Thomas, MAVRAKANAS, Thomas. Mineralocorticoid receptor antagonists in patients with chronic kidney disease. In: Pharmacology & Therapeutics, 2021, vol. 219, p. 107701. doi: 10.1016/j.pharmthera.2020.107701
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Article (Published version)
ISSN of the journal0163-7258

Technical informations

Creation10/15/2020 10:03:00 AM
First validation10/15/2020 10:03:00 AM
Update time03/16/2023 12:02:58 AM
Status update03/16/2023 12:02:57 AM
Last indexation08/31/2023 12:34:39 AM
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