pharmaceuticals Review Mineralocorticoid Receptor Antagonists in Diabetic Kidney Disease Nina Vodošek Hojs 1,* , Sebastjan Bevc 1,2, Robert Ekart 2,3 , Nejc Piko 3 , Tadej Petreski 1,2 and Radovan Hojs 1,2 1 Department of Nephrology, Clinic for Internal Medicine, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia;
[email protected] (S.B.);
[email protected] (T.P.);
[email protected] (R.H.) 2 Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia;
[email protected] 3 Department of Dialysis, Clinic for Internal Medicine, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia;
[email protected] * Correspondence:
[email protected]; Tel.: +386-41-366-133; Fax: +386-2-321-28-45 Abstract: Diabetes mellitus is a global health issue and main cause of chronic kidney disease. Both diseases are also linked through high cardiovascular morbidity and mortality. Diabetic kidney disease (DKD) is present in up to 40% of diabetic patients; therefore, prevention and treatment of DKD are of utmost importance. Much research has been dedicated to the optimization of DKD treatment. In the last few years, mineralocorticoid receptor antagonists (MRA) have experienced a renaissance in this field with the development of non-steroidal MRA. Steroidal MRA have known cardiorenal benefits, but their use is limited by side effects, especially hyperkalemia. Non-steroidal MRA still block the damaging effects of mineralocorticoid receptor overactivation (extracellular fluid volume expansion, inflammation, fibrosis), but with fewer side effects (hormonal, hyperkalemia) Citation: Vodošek Hojs, N.; Bevc, S.; than steroidal MRA. This review article summarizes the current knowledge and newer research Ekart, R.; Piko, N.; Petreski, T.; Hojs, conducted on MRA in DKD.