ReviewHypertension research : official journal of the Japanese Society of Hypertension2015
The necessity and effectiveness of mineralocorticoid receptor antagonist in the treatment of diabetic nephropathy.
Review in Hypertension research : official journal of the Japanese Society of Hypertension, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 26 citations in OpenAlex.
- A 10-year observational study of the effects of serum 25OH vitamin D levels on the onset of prediabetes at a preventive medicine research center.Endocrine journal · 2025Observational
- Network pharmacology and molecular docking technology-based predictive study of the active ingredients and potential targets of rhubarb for the treatment of diabetic nephropathy.BMC complementary medicine and therapies · 2022Article
- Clinical effect of nonsteroidal mineralocorticoid receptor (MR) antagonists in the treatment of diabetic kidney disease: expectations as a new therapeutic strategy.Hypertension research : official journal of the Japanese Society of Hypertension · 2022Review
- Systematic indication extension for drugs using patient stratification insights generated by combinatorial analytics.Patterns (New York, N.Y.) · 2022Review
- The Ascent of Mineralocorticoid Receptor Antagonists in Diabetic Nephropathy.Current clinical pharmacology · 2019Review
- Lipocalin-2 derived from adipose tissue mediates aldosterone-induced renal injury.JCI insight · 2018Article
- Efficiency and specificity of RAAS inhibitors in cardiovascular diseases: how to achieve better end-organ protection?Hypertension research : official journal of the Japanese Society of Hypertension · 2017Review
- Blood pressure management in patients with type 2 diabetes mellitus.Hypertension research : official journal of the Japanese Society of Hypertension · 2017Review
- Intrarenal renin-angiotensin system activity is augmented after initiation of dialysis.Hypertension research : official journal of the Japanese Society of Hypertension · 2017Article
- Circadian blood pressure rhythm as a possible key target of SGLT2 inhibitors used for the treatment of Type 2 diabetes.Hypertension research : official journal of the Japanese Society of Hypertension · 2016Article
- Hyporeninemic hypoaldosteronism and diabetes mellitus: Pathophysiology assumptions, clinical aspects and implications for management.World journal of diabetes · 2016Review
- Improvements in the Management of Diabetic Nephropathy.The review of diabetic studies : RDSReview
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Diabetes mellitus is a major cause of chronic kidney disease (CKD), and diabetic nephropathy is the most common primary disease necessitating dialysis treatment in the world including Japan. Major guidelines for treatment of hypertension in Japan, the United States and Europe recommend the use of angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers, which suppress the renin-angiotensin system (RAS), as the antihypertensive drugs of first choice in patients with coexisting diabetes. However, even with the administration of RAS inhibitors, failure to achieve adequate anti-albuminuric, renoprotective effects and a reduction in cardiovascular events has also been reported. Inadequate blockade of aldosterone may be one of the reasons why long-term administration of RAS inhibitors may not be sufficiently effective in patients with diabetic nephropathy. This review focuses on treatment in diabetic nephropathy and discusses the significance of aldosterone blockade. In pre-nephropathy without overt nephropathy, a mineralocorticoid receptor antagonist can be used to enhance the blood pressure-lowering effects of RAS inhibitors, improve insulin resistance and prevent clinical progression of nephropathy. In CKD categories A2 and A3, the addition of a mineralocorticoid receptor antagonist to an RAS inhibitor can help to maintain 'long-term' antiproteinuric and anti-albuminuric effects. However, in category G3a and higher, sufficient attention must be paid to hyperkalemia. Mineralocorticoid receptor antagonists are not currently recommended as standard treatment in diabetic nephropathy. However, many studies have shown promise of better renoprotective effects if mineralocorticoid receptor antagonists are appropriately used.
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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 Socratic graph.