Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya6495610.26442/00403660.2023.09.202367ReviewsОбзорыReview ArticleThe role of mineralocorticoid receptors hyperactivation in the development of cardiorenal complications in patients with diabetes mellitus, perspective of the selective nonsteroidal mineralocorticoid receptors antagonist’s treatment: A reviewРоль гиперактивации минералокортикоидных рецепторов в развитии кардиоренальных осложнений у пациентов с сахарным диабетом, перспективы применения селективных нестероидных антагонистов минералокортикоидных рецепторовhttps://orcid.org/0000-0002-8007-5680BobkovaIrina N.БобковаИрина Николаевна
Russian Federation

Doctor of Medical Sciences, Professor of the Department of Internal, Occupational Diseases and Rheumatology

доктор медицинских наук, профессор кафедры внутренних, профессиональных болезней и ревматологии

bobkova_i_n@staff.sechenov.ruSechenov First Moscow State Medical University (Sechenov University)ФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова» Минздрава России (Сеченовский Университет)031120239597968010704202107042021Copyright ©; 2023, Consilium MedicumCopyright ©; 2023, ООО "Консилиум Медикум"2023Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/64956

The renin-angiotensin-aldosterone system (RAAS) activation plays a key role in the chronic kidney disease (CKD) progression and in the cardiovascular complications (CVC) development in patients with diabetes mellitus (DM). RAAS blockers alone are not sufficient to prevent CVC and CVC progression. RAAS upregulation in CKD associated with DM triggers the mineralocorticoid receptors (MCR) hyperactivation which results in fibrosis and inflammation in the heart and kidneys. This review presents the current data about the variety of MCR hyperactivation manifestations, as well as about of multiplicity of MCR hyperactivation ways in DM. The efficacy and safety of finerenone, a new MCR nonsteroidal selective antagonist, are discussed.

Активация ренин-ангиотензин-альдостероновой системы (РААС) играет ключевую роль в прогрессировании хронической болезни почек (ХБП) и развитии сердечно-сосудистых осложнений у пациентов с сахарным диабетом (СД). Одних только блокаторов РААС недостаточно для предотвращения прогрессирования ХБП и сердечно-сосудистых осложнений. Повышенная регуляция РААС при ХБП, ассоциированной с СД, запускает гиперактивацию минералокортикоидных рецепторов (МКР), что приводит к фиброзу и воспалению в сердце и почках. В настоящем обзоре представлены современные данные о разнообразии и системности проявлений, а также о множественности путей активации МКР при СД и ХБП. Обсуждаются эффективность и безопасность финеренона, нового нестероидного селективного антагониста MКР.

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