scholarly journals Rationale and design of the Mineralocorticoid Receptor Antagonists in End-Stage Renal Disease Study (MiREnDa)

2013 ◽  
Vol 29 (2) ◽  
pp. 400-405 ◽  
Author(s):  
F. Hammer ◽  
V. Krane ◽  
S. Stork ◽  
C. Roser ◽  
K. Hofmann ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Mineralocorticoid Receptor ◽  
Mineralocorticoid Receptor Antagonists ◽  
Receptor Antagonists ◽  
Disease Study ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Mineralocorticoid Receptor Antagonists in End-Stage Renal Disease: Efficacy and Safety

2016 ◽  
Vol 41 (1-3) ◽  
pp. 166-170 ◽  
Author(s):  
Andrew S. Bomback
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Mineralocorticoid Receptor ◽  
Left Ventricular ◽  
Efficacy And Safety ◽  
Mineralocorticoid Receptor Antagonists ◽  
Receptor Antagonists ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Mineralocorticoid receptor antagonists (MRAs) that block aldosterone's effects on both epithelial and non-epithelial receptors have become a mainstay of therapy for chronic heart failure. Given that cardiovascular events remain the leading cause of death for patients with end-stage renal disease (ESRD), the question of whether these MRAs can be employed in dialysis patients arises. This review summarizes the rationale for blocking aldosterone in patients with chronic and end-stage kidney disease and surveys the data on both the efficacy and safety of using MRAs in the ESRD population. A small but growing body of literature suggests that use of MRAs by ESRD patients is associated with lower blood pressure, reduced left ventricular (LV) mass, and improved LV ejection fraction. Recently, a large randomized trial found an overall 3-year mortality rate of 6.4% in ESRD patients on spironolactone 25 mg daily vs. 19.7% in ESRD patients on no MRA therapy (p = 0.002), without a significantly increased risk of hyperkalemia.

scholarly journals Mineralocorticoid Receptor Antagonism for Cardiovascular Protection in End-Stage Renal Disease: New Data But the Controversy Continues

2015 ◽  
Vol 18 (3) ◽  
pp. 197-199 ◽  
Author(s):  
Panagiotis I. Georgianos ◽  
Pantelis A. Sarafidis ◽  
Vassilios Liakopoulos ◽  
Elias V. Balaskas ◽  
Pantelis E. Zebekakis
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Mineralocorticoid Receptor ◽  
Receptor Antagonism ◽  
Cardiovascular Protection ◽  
Mineralocorticoid Receptor Antagonism ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals The Ascent of Mineralocorticoid Receptor Antagonists in Diabetic Nephropathy

2019 ◽  
Vol 14 (2) ◽  
pp. 78-83 ◽  
Author(s):  
Luxitaa Goenka ◽  
Raghavan Padmanaban ◽  
Melvin George
Keyword(s):  
Diabetic Nephropathy ◽  
Mineralocorticoid Receptor ◽  
Enzyme Inhibitor ◽  
Angiotensin Receptor Blockers ◽  
Renal Diseases ◽  
Channel Blockers ◽  
Mineralocorticoid Receptor Antagonists ◽  
Receptor Antagonists ◽  
Stage Renal Disease ◽  
End Stage

Diabetic nephropathy is defined as a decline in the renal function and an increase in the amount of albuminuria (>300 mg/day). The interruption of the renin-angiotensin-aldosterone system (RAAS) by well-established therapies such as angiotensin-converting enzyme inhibitor, angiotensin receptor blockers, calcium channel blockers or diuretics has been beneficial in reducing the progression of renal diseases; however, there is an increase in the levels of aldosterone due to the aldosterone escape phenomenon. Newer and novel approaches to counteract this aldosterone breakthrough while accentuating the anti-hypertensive and anti-proteinuric effects of these agents would be ideal and mineralocorticoid receptor antagonists fit in this slot perfectly. This review attempted to evaluate the safety and efficacy of and mineralocorticoid receptor antagonists for diabetic nephropathy. Presently mineralocorticoid receptor antagonists such as spironolactone, eplerenone and finerenone are being investigated as both monotherapies and as additional therapies. Clinical studies have shown that these drugs have been effective in the reduction of blood pressure, urinaryalbumin- excretion and estimated glomerular filtration rate. The commonly observed adverse effects are hyperkalemia, gynaecomastia and vaginal bleeding, that are bothersome with spironolactone seems to be avoidable if these patients are switched to non-steroidal and mineralocorticoid receptor antagonists such as finerenone and eplerenone. Most of the studies have only evaluated the shortterm effects of mineralocorticoid receptor antagonists on diabetic nephropathy. Hard outcomes such as cardiovascular events, creatinine doubling, progression to end-stage renal disease, mortality and the need for temporary or permanent dialysis need to be studied with these molecules.

Sign in / Sign up

Export Citation Format

Share Document