Nwamaka Osakwe In a retrospective study, researchers demonstrated that one class of drug was associated with lower rates of renal replacement therapy (RRT) among chronic kidney disease patients.
Chronic kidney disease (CKD) affects 1 in 10 individuals globally. One management strategy is to slow the progression of the disease. Unfortunately, despite using guideline drugs and recommendations, the number of patients requiring RRT is increasing.
Reports suggest the mineralocorticoid receptor antagonist (MRA) class of drugs protects the kidneys. Drugs belonging to this class include spironolactone, eplerenone and recently finerenone. In addition, they reduce kidney injury and scarring by suppressing inflammation and oxidative stress. Studies have shown that MRAs are effective in patients with diabetes mellitus with protein in their urine. But, this study looks at real-world data in various groups of patients and not just those with diabetes.
One challenge with MRAs is the risk of hyperkalemia (elevated potassium levels). Hyperkalemia is life-threatening and causes nausea, vomiting, heart rhythm changes, and a heart attack. In this study, although potassium levels were higher among patients on MRAs, it was not statistically different from the control group.
What to know about chronic kidney disease
Chronic kidney disease is caused by various factors, including hypertension, glomerular diseases, lupus, malignancy, urinary obstruction, certain medications and toxins. CKD causes progressive loss of kidney function until the person develops end-stage disease or kidney failure. This loss of kidney function results in a dangerous accumulation of wastes in the body. Other body functions also break down. As such, patients develop fatigue, loss of appetite, body swelling, low hemoglobin, urinary symptoms and, in severe cases, seizures and loss of consciousness.
Health care providers treat symptoms and aim to slow down the progression of the disease. Research is always ongoing for strategies and drugs that slow disease progression. If this class of drugs proves effective, having one more tool in kidney disease management is good news.
REFERENCES
Oka T, Sakaguchi Y, Hattori K, et al. Mineralocorticoid Receptor Antagonist Use and Hard Renal Outcomes in Real-World Patients With Chronic Kidney Disease. Hypertension. 2022;79(3):679-689. doi:10.1161/HYPERTENSIONAHA.121.18360