■Finerenone已被批准用于治疗糖尿病肾病(DKD),降低心肾风险。目前缺乏用于DKD管理的finenone治疗的实际数据。本研究旨在首次在现实医学环境中探讨菲雷酮对中国DKD人群肾脏参数的影响。特别是与肾素-血管紧张素系统抑制剂(RASi)和钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)联合使用。
■选择42例DKD患者并完成6个月的finenerone治疗。每次就诊时收集肾脏参数和不良反应。
■尿白蛋白与肌酐比值中位数(UACR)为1426.11(755.42,3638.23)mg/g。其中,UACR为300-5000mg/g的患者比例为76.2%,UACR>5000mg/g的患者比例为14.3%。估计肾小球滤过率(eGFR)的中位数为54.50(34.16,81.73)mL/min/1.73m2。Finenerone在整个研究期间显着降低UACR(p<0.05)。在第6个月,UACR的最大下降为73%。此外,在第6个月,UACR降低30%或更多的患者比例为68.42%.开始使用finenerone后,eGFR的下降幅度较小(9-11%)(p>.05)。由于高钾血症(2.4%)和急性肾损伤(2.4%),每位患者均停用了finetenone。没有病人报告低血压,乳房疼痛,和男性乳房发育症。
■这项来自中国的研究首次表明,在现实世界的DKD治疗中,finerenone降低了UACR,具有可控的安全性。RASi的三联疗法,SGLT2i,在晚期DKD患者中,对于降低白蛋白尿和降低高钾血症风险可能是一种有前景的治疗策略.
UNASSIGNED: Finerenone has been approved for treating diabetic kidney disease (DKD) with reducing cardiorenal risk. Real-world data on finerenone treatment for the management of DKD are presently lacking. This study aimed to investigate the effect of finerenone on the renal parameters of the Chinese DKD population in the real-world medical setting for the first time, especially in combination with renin-angiotensin system inhibitors (RASi) and sodium-glucose cotransporter 2 inhibitors (SGLT2i).
UNASSIGNED: Forty-two DKD patients were selected and completed a 6-month finerenone treatment. Renal parameters and adverse effects were collected at every visit.
UNASSIGNED: The median urine albumin-to-creatinine ratio (UACR) was 1426.11 (755.42, 3638.23) mg/g. Among them, the proportion of patients with a UACR of 300-5000 mg/g was 76.2%, and the proportion of patients with a UACR of >5000 mg/g was 14.3%. The median estimated glomerular filtration rate (eGFR) was 54.50 (34.16, 81.73) mL/min/1.73 m2. Finerenone decreased the UACR significantly throughout the study period (p < .05). The maximal decline of UACR at month 6 was 73%. Moreover, the proportion of patients with a 30% or greater reduction in UACR was 68.42% in month 6. There was a smaller decline (9-11%) in the eGFR after initiating finerenone (p > .05). One patient each discontinued finerenone due to hyperkalemia (2.4%) and acute kidney injury (2.4%). No patient reported hypotension, breast pain, and gynecomastia.
UNASSIGNED: This study from China first demonstrated finerenone decreased UACR with manageable safety in real-world DKD treatment. A triple regimen of RASi, SGLT2i, and finerenone may be a promising treatment strategy for lowering albuminuria and reducing hyperkalemia risk in advanced DKD patients.