Mineralocorticoid receptor blockage in kidney transplantation: too much of a good thing or not?

Autor: Afsar B; School of Medicine, Division of Nephrology, Saint Louis University, SSM Health Saint Louis University Hospital, St. Louis, MO, USA. afsarbrs@yahoo.com., Afsar RE; School of Medicine, Division of Nephrology, Saint Louis University, SSM Health Saint Louis University Hospital, St. Louis, MO, USA., Caliskan Y; School of Medicine, Division of Nephrology, Saint Louis University, SSM Health Saint Louis University Hospital, St. Louis, MO, USA., Lentine KL; School of Medicine, Division of Nephrology, Saint Louis University, SSM Health Saint Louis University Hospital, St. Louis, MO, USA.
Jazyk: angličtina
Zdroj: International urology and nephrology [Int Urol Nephrol] 2024 Oct 29. Date of Electronic Publication: 2024 Oct 29.
DOI: 10.1007/s11255-024-04256-6
Abstrakt: Although, kidney transplantation (KT) is the best treatment option for patients with end-stage kidney disease, long-term complications including chronic kidney allograft disease (CKAD) and major adverse cardiovascular events (MACE) are common. To decrease these complications new therapeutic options are necessary. Mineralocorticoid receptor antagonists (MRAs) are one of the promising drugs in this context. In the general population, MRAs had favorable effects on blood pressure regulation, MACE, proteinuria and progression of chronic kidney disease. In the context of KT, there are limited studies showing beneficial effects such as reducing proteinuria and oxidative stress. In this review, we performed a narrative review to assess the use and impact of MRAs in kidney transplant recipients. We found that in KTRs, MRAs are safe and they have favorable or neutral impact on blood pressure, glomerular filtration rate, urinary protein/albumin excretion, and oxidative stress. No data was found regarding major cardiovascular adverse events.
(© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
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