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Overall, MR signaling is best regarded as a biologically plausible contributor within a multifactorial residual-risk model; prospective validation is required before biomarker-guided MR-targeted therapy can be recommended.
This review distinguishes aldosterone excess from MR activation and proposes a nephrology-focused clinical framework separating established MRA indications, evaluation for primary aldosteronism, and the unestablished cardiorenal outcome role of aldosterone synthase inhibitors (ASIs).
Cardiovascular-kidney-metabolic (CKM) syndrome represents the interconnected pathophysiology of metabolic risk factors, chronic kidney disease (CKD), and cardiovascular disease, leading to multiorgan dysfunction and elevated adverse outcomes. Overactivation of the mineralocorticoid receptor (MR), via aldosterone-depend...
Background/Objectives: Patients with chronic kidney disease (CKD), although treated with optimal renin–angiotensin–aldosterone system (RAAS) blockade, remain at substantial residual risk of disease progression and cardiovascular events. The recent arrival of sodium-glucose cotransporter-2 (SGLT2) inhibitors, and non-st...
Mineralocorticoid receptor antagonists (MRAs) are foundational in cardiorenal therapy, yet head-to-head comparisons across specific clinical phenotypes are scarce. This real-world study evaluates the comparative effectiveness and safety of various MRAs in patients with heart failure (HF), chronic kidney disease (...
Proteinuria remains a cardinal surrogate of renal injury and cardiorenal risk, However, residual albuminuria is commonly observed after the treatment with renin-angiotensin-aldosterone system (RAAS) blockade or sodium-glucose cotransporter-2 inhibitors (SGLT2i). The non-steroidal, selective mineralocorticoid receptor a...
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