Evidence map›Paper›PMID 34675379›Full record

ReviewNature reviews. Nephrology2022

Mineralocorticoid receptor antagonists in diabetic kidney disease - mechanistic and therapeutic effects.

Jonatan Barrera-Chimal, Ixchel Lima-Posada, George L Bakris, Frederic Jaisser

Registry-linked trialAbstract readReview
PubMed Publisher
In one paragraph

Review in Nature reviews. Nephrology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07356388 (An Study on the Efficacy and Safety of Finerenone in Proteinuria Patients After Kidney Transplantation), which is not on this map. Cited by 145 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
145citing papers in PubMed, 9 pooled it
21.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07356388 phase3active not recruitingnot on this mapstarted 2025, after this paper: background citation

An Study on the Efficacy and Safety of Finerenone in Proteinuria Patients After Kidney Transplantation

TypeinterventionalSponsorkewen Chen,MDRan2025 to 2028Enrolled54ConditionsKidney Transplantation Recipients, Proteinuria PatientsArmsExperimental Group, Control (Standard treatment)
3 · Its place in the literature

Who cites it

145 citing papers in PubMed, 9 syntheses or guidelines pooled it, 217 citations in OpenAlex.

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85 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 3 countries.

Jonatan Barrera-ChimalInstituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico.ORCID http://orcid.org/0000-0002-0711-5092
Ixchel Lima-PosadaINSERM, UMRS 1138, Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Paris, France.
George L BakrisAmerican Heart Association Comprehensive Hypertension Centre, Department of Medicine, University of Chicago Medicine, Chicago, IL, USA.
Frederic JaisserINSERM, UMRS 1138, Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Paris, France. frederic.jaisser@inserm.fr.ORCID http://orcid.org/0000-0001-9051-1901
Inserm · FRAmerican Heart Association · USInstituto Nacional de Cardiología · MX

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic kidney disease (CKD) is the leading complication in type 2 diabetes (T2D) and current therapies that limit CKD progression and the development of cardiovascular disease (CVD) include angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and sodium-glucose co-transporter 2 (SGLT2) inhibitors. Despite the introduction of these therapeutics, an important residual risk of CKD progression and cardiovascular death remains in patients with T2D. Mineralocorticoid receptor antagonists (MRAs) are a promising therapeutic option in diabetic kidney disease (DKD) owing to the reported effects of mineralocorticoid receptor activation in inflammatory cells, podocytes, fibroblasts, mesangial cells and vascular cells. In preclinical studies, MRAs consistently reduce albuminuria, CKD progression, and activation of fibrotic and inflammatory pathways. DKD clinical studies have similarly demonstrated that steroidal MRAs lead to albuminuria reduction compared with placebo, although hyperkalaemia is a major secondary effect. Non-steroidal MRAs carry a lower risk of hyperkalaemia than steroidal MRAs, and the large FIDELIO-DKD clinical trial showed that the non-steroidal MRA finerenone also slowed CKD progression and reduced the risk of adverse cardiovascular outcomes compared with placebo in patients with T2D. Encouragingly, other non-steroidal MRAs have anti-albuminuric properties in DKD. Whether or not combining MRAs with other renoprotective drugs such as SGLT2 inhibitors might provide additive protective effects warrants further investigation.

Indexed as

Diabetes Mellitus, Type 2Diabetic NephropathiesAlbuminuriaAngiotensin-Converting Enzyme InhibitorsHumansMineralocorticoid Receptor AntagonistsAngiotensin-Converting Enzyme InhibitorsMineralocorticoid Receptor Antagonists

Identifiers

PMID34675379
OpenAlexW3205935676

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.