作者：李雯静，杨小娟

单位：

延安大学附属医院肾内科

Units：

Renal Medicine, Yanan University Affiliated Hospital, Yan'an 716000, China

关键词：

糖尿病肾病; 盐皮质激素受体拮抗剂; 非奈利酮; 综述;

Keywords：

　Diabetic nephropathies; Mineralocorticoid receptor antagonists; Finerenone; Review

CLC：

DOI：

10.12114/j.issn.1008-5971.2023.00.067

Funds：

摘要：

糖尿病肾病（DKD）是糖尿病的严重并发症，心血管事件和终末期肾脏病（ESRD）是DKD患者死亡的主要原因。近20年来，降糖、降脂和阻断肾素-血管紧张素-醛固酮系统（RAAS）治疗虽然可以降低DKD患者尿蛋白，抑制其肾脏纤维化，但对肾脏和心血管结局的改善作用有限。研究表明，盐皮质激素受体（MR）过度活化可触发炎症和肾脏纤维化，导致DKD进展。非奈利酮是一种新型非甾体类盐皮质激素受体拮抗剂（MRA），其可以使DKD患者心肾双重获益。本研究主要综述了MRA治疗DKD的机制及非奈利酮治疗DKD的有效性、安全性，以期为非奈利酮治疗DKD提供证据支持。

Abstract：

Diabetic kidney disease (DKD) is a serious complication of diabetes mellitus. Cardiovascular events and end-stage renal disease (ESRD) are the main causes of death in DKD patients. In the past 20 years, although hypoglycemic, lipid?lowering and blocking renin-angiotensin-aldosterone system (RAAS) treatment can reduce proteinuria and inhibit renal fibrosis in DKD patients, the improvement of renal and cardiovascular outcomes is limited. Studies have shown that excessive activation of mineralocorticoid receptor (MR) can trigger inflammation and renal fibrosis, leading to the progression of DKD. Non-nalidone is a new type of non-steroidal mineralocorticoid receptor antagonist (MRA) , which can benefit both heart and kidney in DKD patients. This study mainly reviews the mechanism of MRA in the treatment of DKD and the efficacy and safety of non-nalidone in the treatment of DKD, in order to provide evidence support for the treatment of DKD with non-nalidone.

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