ReviewClinical kidney journal2026
PRO/CON debate: nonsteroidal versus steroidal mineralocorticoid receptor antagonists in chronic kidney disease: progress, pragmatism, and remaining uncertainties.
Review in Clinical kidney journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
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0 citing papers in PubMed.
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Mineralocorticoid receptor antagonists (MRAs) are a central component of contemporary cardiorenal protection in chronic kidney disease (CKD). Classic steroidal MRAs, spironolactone and eplerenone, have long been used to treat hypertension and heart failure and to reduce albuminuria, but their wider use in CKD has been constrained by hyperkalaemia and endocrine side-effects. Nonsteroidal MRAs (nsMRAs), typified by finerenone, were developed to maintain antiproteinuric and antifibrotic efficacy while improving tissue selectivity, pharmacokinetics, and tolerability. Large outcome trials in type 2 diabetes with albuminuric CKD show that finerenone reduces the risk of kidney failure and major cardiovascular events when added to renin-angiotensin system (RAS) blockade and, more recently, in combination with SGLT2 inhibition. At the same time, the superior blood pressure-lowering capacity, low cost, and global availability of steroidal MRAs remain compelling, particularly in resistant hypertension and resource-constrained settings. This pro/con debate contrasts the case for nsMRAs with that for classic steroidal MRAs and explores how best to deploy each class across heterogeneous CKD populations.
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