The potential role of finerenone in patients with type 1 diabetes and chronic kidney disease
Chronic kidney disease (CKD) represents a global health concern, associated with an increased risk of cardiovascular morbidity and mortality and decreased quality of life. Many patients with type 1 diabetes (T1D) will develop CKD over their lifetime. Uncontrolled glucose levels, which occur in patie...
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Veröffentlicht in: | Diabetes, obesity & metabolism obesity & metabolism, 2024-10, Vol.26 (10), p.4135-4146 |
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description | Chronic kidney disease (CKD) represents a global health concern, associated with an increased risk of cardiovascular morbidity and mortality and decreased quality of life. Many patients with type 1 diabetes (T1D) will develop CKD over their lifetime. Uncontrolled glucose levels, which occur in patients with T1D as well as type 2 diabetes (T2D), are associated with substantial mortality and cardiovascular disease burden. T2D and T1D share common pathological features of CKD, which is thought to be driven by haemodynamic dysfunction, metabolic disturbances, and subsequently an influx of inflammatory and profibrotic mediators, both of which are major interrelated contributors to CKD progression. The mineralocorticoid receptor is also involved, and, under conditions of oxidative stress, salt loading and hyperglycaemia, it switches from homeostatic regulator to pathophysiological mediator by promoting oxidative stress, inflammation and fibrosis. Progressive glomerular and tubular injury leads to macroalbuminuria a progressive reduction in the glomerular filtration rate and eventually end‐stage renal disease. Finerenone, a non‐steroidal, selective mineralocorticoid receptor antagonist, is approved for treatment of patients with CKD associated with T2D; however, the benefit of finerenone in patients with T1D has yet to be determined. This narrative review will discuss treatment of CKD in T1D and the potential future role of finerenone in this setting. |
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Many patients with type 1 diabetes (T1D) will develop CKD over their lifetime. Uncontrolled glucose levels, which occur in patients with T1D as well as type 2 diabetes (T2D), are associated with substantial mortality and cardiovascular disease burden. T2D and T1D share common pathological features of CKD, which is thought to be driven by haemodynamic dysfunction, metabolic disturbances, and subsequently an influx of inflammatory and profibrotic mediators, both of which are major interrelated contributors to CKD progression. The mineralocorticoid receptor is also involved, and, under conditions of oxidative stress, salt loading and hyperglycaemia, it switches from homeostatic regulator to pathophysiological mediator by promoting oxidative stress, inflammation and fibrosis. Progressive glomerular and tubular injury leads to macroalbuminuria a progressive reduction in the glomerular filtration rate and eventually end‐stage renal disease. Finerenone, a non‐steroidal, selective mineralocorticoid receptor antagonist, is approved for treatment of patients with CKD associated with T2D; however, the benefit of finerenone in patients with T1D has yet to be determined. This narrative review will discuss treatment of CKD in T1D and the potential future role of finerenone in this setting.</description><identifier>ISSN: 1462-8902</identifier><identifier>ISSN: 1463-1326</identifier><identifier>EISSN: 1463-1326</identifier><identifier>DOI: 10.1111/dom.15773</identifier><identifier>PMID: 39021345</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>cardiovascular disease ; Cardiovascular diseases ; chronic kidney disease ; Diabetes ; Diabetes mellitus (insulin dependent) ; Diabetes mellitus (non-insulin dependent) ; Fibrosis ; finerenone ; Glomerular filtration rate ; Hyperglycemia ; Kidney diseases ; Mineralocorticoid receptors ; Morbidity ; Mortality ; Oxidative stress ; Public health ; Quality of life ; Salt loading ; type 1 diabetes</subject><ispartof>Diabetes, obesity & metabolism, 2024-10, Vol.26 (10), p.4135-4146</ispartof><rights>2024 The Author(s). published by John Wiley & Sons Ltd.</rights><rights>2024 The Author(s). 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Many patients with type 1 diabetes (T1D) will develop CKD over their lifetime. Uncontrolled glucose levels, which occur in patients with T1D as well as type 2 diabetes (T2D), are associated with substantial mortality and cardiovascular disease burden. T2D and T1D share common pathological features of CKD, which is thought to be driven by haemodynamic dysfunction, metabolic disturbances, and subsequently an influx of inflammatory and profibrotic mediators, both of which are major interrelated contributors to CKD progression. The mineralocorticoid receptor is also involved, and, under conditions of oxidative stress, salt loading and hyperglycaemia, it switches from homeostatic regulator to pathophysiological mediator by promoting oxidative stress, inflammation and fibrosis. Progressive glomerular and tubular injury leads to macroalbuminuria a progressive reduction in the glomerular filtration rate and eventually end‐stage renal disease. Finerenone, a non‐steroidal, selective mineralocorticoid receptor antagonist, is approved for treatment of patients with CKD associated with T2D; however, the benefit of finerenone in patients with T1D has yet to be determined. This narrative review will discuss treatment of CKD in T1D and the potential future role of finerenone in this setting.</description><subject>cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>chronic kidney disease</subject><subject>Diabetes</subject><subject>Diabetes mellitus (insulin dependent)</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Fibrosis</subject><subject>finerenone</subject><subject>Glomerular filtration rate</subject><subject>Hyperglycemia</subject><subject>Kidney diseases</subject><subject>Mineralocorticoid receptors</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Oxidative stress</subject><subject>Public health</subject><subject>Quality of life</subject><subject>Salt loading</subject><subject>type 1 diabetes</subject><issn>1462-8902</issn><issn>1463-1326</issn><issn>1463-1326</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp1kE1LxDAQhoMofh_8AxLwoodq0mnT7lHWT1C86E0IaTJho92kJl1k_73RVQ-CuUyYeeZleAg54OyU53dmwvyU100Da2SbVwIKDqVY__qXRTth5RbZSemFMVZB22ySLcg9DlW9TZ4fZ0iHMKIfneppDD3SYKl1HiP64JE6Twc1ugwk-u7GGR2XA1JOjVMdjpio8obqWQzeafrqjMdlniVUCffIhlV9wv3vukueri4fpzfF3cP17fT8rtDAAQrFrOlqXdXQWY4WWmGtEaVuqraurGW85pXpgLW1MgCVEFwbZkpRiq6zqFvYJcer3CGGtwWmUc5d0tj3ymNYJJlXS2CTSd1k9OgP-hIW0efrJHAmshMmWKZOVpSOIaWIVg7RzVVcSs7kp3KZlcsv5Zk9_E5cdHM0v-SP4wycrYB31-Py_yR58XC_ivwAAGeKJg</recordid><startdate>202410</startdate><enddate>202410</enddate><creator>Escobar Vasco, Maria Adelaida</creator><creator>Fantaye, Samuel H.</creator><creator>Raghunathan, Sapna</creator><creator>Solis‐Herrera, Carolina</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0009-0004-1116-4788</orcidid><orcidid>https://orcid.org/0000-0002-6215-9418</orcidid><orcidid>https://orcid.org/0000-0002-3292-8984</orcidid><orcidid>https://orcid.org/0009-0004-2175-2903</orcidid></search><sort><creationdate>202410</creationdate><title>The potential role of finerenone in patients with type 1 diabetes and chronic kidney disease</title><author>Escobar Vasco, Maria Adelaida ; Fantaye, Samuel H. ; Raghunathan, Sapna ; Solis‐Herrera, Carolina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3133-a0fdb5c453bf1ef386ffd62c74854ff01514db3085ad334661cd0d2626bbfec83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>chronic kidney disease</topic><topic>Diabetes</topic><topic>Diabetes mellitus (insulin dependent)</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Fibrosis</topic><topic>finerenone</topic><topic>Glomerular filtration rate</topic><topic>Hyperglycemia</topic><topic>Kidney diseases</topic><topic>Mineralocorticoid receptors</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Oxidative stress</topic><topic>Public health</topic><topic>Quality of life</topic><topic>Salt loading</topic><topic>type 1 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Escobar Vasco, Maria Adelaida</creatorcontrib><creatorcontrib>Fantaye, Samuel H.</creatorcontrib><creatorcontrib>Raghunathan, Sapna</creatorcontrib><creatorcontrib>Solis‐Herrera, Carolina</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes, obesity & metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Escobar Vasco, Maria Adelaida</au><au>Fantaye, Samuel H.</au><au>Raghunathan, Sapna</au><au>Solis‐Herrera, Carolina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The potential role of finerenone in patients with type 1 diabetes and chronic kidney disease</atitle><jtitle>Diabetes, obesity & metabolism</jtitle><addtitle>Diabetes Obes Metab</addtitle><date>2024-10</date><risdate>2024</risdate><volume>26</volume><issue>10</issue><spage>4135</spage><epage>4146</epage><pages>4135-4146</pages><issn>1462-8902</issn><issn>1463-1326</issn><eissn>1463-1326</eissn><abstract>Chronic kidney disease (CKD) represents a global health concern, associated with an increased risk of cardiovascular morbidity and mortality and decreased quality of life. 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Finerenone, a non‐steroidal, selective mineralocorticoid receptor antagonist, is approved for treatment of patients with CKD associated with T2D; however, the benefit of finerenone in patients with T1D has yet to be determined. This narrative review will discuss treatment of CKD in T1D and the potential future role of finerenone in this setting.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>39021345</pmid><doi>10.1111/dom.15773</doi><tpages>12</tpages><orcidid>https://orcid.org/0009-0004-1116-4788</orcidid><orcidid>https://orcid.org/0000-0002-6215-9418</orcidid><orcidid>https://orcid.org/0000-0002-3292-8984</orcidid><orcidid>https://orcid.org/0009-0004-2175-2903</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | cardiovascular disease Cardiovascular diseases chronic kidney disease Diabetes Diabetes mellitus (insulin dependent) Diabetes mellitus (non-insulin dependent) Fibrosis finerenone Glomerular filtration rate Hyperglycemia Kidney diseases Mineralocorticoid receptors Morbidity Mortality Oxidative stress Public health Quality of life Salt loading type 1 diabetes |
title | The potential role of finerenone in patients with type 1 diabetes and chronic kidney disease |
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