{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T16:25:43Z","timestamp":1793291143546,"version":"4.5.0"},"reference-count":74,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Curr Heart Fail Rep"],"DOI":"10.1007\/s11897-026-00740-5","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T06:35:45Z","timestamp":1769754945000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Evolving Mineralocorticoid Receptor Antagonism: a Narrative Review on Differences between Steroidal MRAs, Non-Steroidal MRAs and Aldosterone Synthase Inhibitors in Cardiorenal Disease"],"prefix":"10.1007","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3883-4102","authenticated-orcid":false,"given":"Jonas","family":"Erzeel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marnicq","family":"van Es","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfried","family":"Mullens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"Martens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"issue":"19","key":"740_CR1","doi-asserted-by":"publisher","first-page":"1527","DOI":"10.1016\/j.jacc.2008.07.051","volume":"52","author":"C Ronco","year":"2008","unstructured":"Ronco C, Haapio M, House AA, Anavekar N, Bellomo R. Cardiorenal syndrome. J Am Coll Cardiol. 2008;52(19):1527\u201339.","journal-title":"J Am Coll Cardiol"},{"issue":"9","key":"740_CR2","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1161\/CIRCULATIONAHA.117.028814","volume":"138","author":"F Zannad","year":"2018","unstructured":"Zannad F, Rossignol P. Cardiorenal syndrome revisited. Circulation. 2018;138(9):929\u201344.","journal-title":"Circulation"},{"issue":"5","key":"740_CR3","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1038\/nrneph.2010.30","volume":"6","author":"M Briet","year":"2010","unstructured":"Briet M, Schiffrin EL. Aldosterone: effects on the kidney and cardiovascular system. Nat Rev Nephrol. 2010;6(5):261\u201373.","journal-title":"Nat Rev Nephrol"},{"issue":"10","key":"740_CR4","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1056\/NEJM199909023411001","volume":"341","author":"B Pitt","year":"1999","unstructured":"Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med. 1999;341(10):709\u201317.","journal-title":"N Engl J Med"},{"issue":"14","key":"740_CR5","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1056\/NEJMoa030207","volume":"348","author":"B Pitt","year":"2003","unstructured":"Pitt B, Remme W, Zannad F, Neaton J, Martinez F, Roniker B, et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 2003;348(14):1309\u201321.","journal-title":"N Engl J Med"},{"issue":"1","key":"740_CR6","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1056\/NEJMoa1009492","volume":"364","author":"F Zannad","year":"2011","unstructured":"Zannad F, McMurray JJ, Krum H, van Veldhuisen DJ, Swedberg K, Shi H, et al. Eplerenone in patients with systolic heart failure and mild symptoms. N Engl J Med. 2011;364(1):11\u201321.","journal-title":"N Engl J Med"},{"key":"740_CR7","first-page":"321","volume":"9","author":"JL Guichard","year":"2013","unstructured":"Guichard JL, Clark D 3rd, Calhoun DA, Ahmed MI. Aldosterone receptor antagonists: current perspectives and therapies. Vasc Health Risk Manag. 2013;9:321\u201331.","journal-title":"Vasc Health Risk Manag"},{"issue":"6","key":"740_CR8","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1056\/NEJMra035279","volume":"351","author":"BF Palmer","year":"2004","unstructured":"Palmer BF. Managing hyperkalemia caused by inhibitors of the renin-angiotensin-aldosterone system. N Engl J Med. 2004;351(6):585\u201392.","journal-title":"N Engl J Med"},{"issue":"2","key":"740_CR9","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1016\/j.mce.2011.06.025","volume":"350","author":"P Kolkhof","year":"2012","unstructured":"Kolkhof P, Borden SA. Molecular pharmacology of the mineralocorticoid receptor: prospects for novel therapeutics. Mol Cell Endocrinol. 2012;350(2):310\u20137.","journal-title":"Mol Cell Endocrinol"},{"key":"740_CR10","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2021.105859","volume":"172","author":"P Kolkhof","year":"2021","unstructured":"Kolkhof P, Joseph A, Kintscher U. Nonsteroidal mineralocorticoid receptor antagonism for cardiovascular and renal disorders - new perspectives for combination therapy. Pharmacol Res. 2021;172:105859.","journal-title":"Pharmacol Res"},{"issue":"23","key":"740_CR11","doi-asserted-by":"publisher","first-page":"2219","DOI":"10.1056\/NEJMoa2025845","volume":"383","author":"GL Bakris","year":"2020","unstructured":"Bakris GL, Agarwal R, Anker SD, Pitt B, Ruilope LM, Rossing P, et al. Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes. N Engl J Med. 2020;383(23):2219\u201329.","journal-title":"N Engl J Med"},{"issue":"6","key":"740_CR12","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1161\/CIRCULATIONAHA.120.051898","volume":"143","author":"G Filippatos","year":"2021","unstructured":"Filippatos G, Anker SD, Agarwal R, Pitt B, Ruilope LM, Rossing P, et al. Finerenone and cardiovascular outcomes in patients with chronic kidney disease and type 2 diabetes. Circulation. 2021;143(6):540\u201352.","journal-title":"Circulation"},{"issue":"24","key":"740_CR13","doi-asserted-by":"publisher","first-page":"2252","DOI":"10.1056\/NEJMoa2110956","volume":"385","author":"B Pitt","year":"2021","unstructured":"Pitt B, Filippatos G, Agarwal R, Anker SD, Bakris GL, Rossing P, et al. Cardiovascular events with finerenone in kidney disease and type 2 diabetes. N Engl J Med. 2021;385(24):2252\u201363.","journal-title":"N Engl J Med"},{"key":"740_CR14","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14103598","author":"M Zaheen","year":"2025","unstructured":"Zaheen M, Ferdous F, Amarasekera AT, Petutschnigg J, Edelmann F, Tan TC. Mineralocorticoid receptor antagonists in heart failure with preserved ejection fraction: a systematic review and meta-analysis. J Clin Med. 2025. https:\/\/doi.org\/10.3390\/jcm14103598.","journal-title":"J Clin Med"},{"issue":"5","key":"740_CR15","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1016\/j.jacc.2025.06.012","volume":"86","author":"F Fioretti","year":"2025","unstructured":"Fioretti F, Testani JM, Tio MC, Pitt B, Butler J. Aldosterone and aldosterone modulation in cardio-kidney diseases. J Am Coll Cardiol. 2025;86(5):354\u201373.","journal-title":"J Am Coll Cardiol"},{"issue":"3","key":"740_CR16","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1161\/01.HYP.0000201443.63240.a7","volume":"47","author":"EL Schiffrin","year":"2006","unstructured":"Schiffrin EL. Effects of aldosterone on the vasculature. Hypertension. 2006;47(3):312\u20138.","journal-title":"Hypertension"},{"issue":"4","key":"740_CR17","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1161\/HYPERTENSIONAHA.109.149062","volume":"55","author":"T Fujita","year":"2010","unstructured":"Fujita T. Mineralocorticoid receptors, salt-sensitive hypertension, and metabolic syndrome. Hypertension. 2010;55(4):813\u20138.","journal-title":"Hypertension"},{"issue":"12","key":"740_CR18","doi-asserted-by":"publisher","first-page":"1932","DOI":"10.1038\/s41440-019-0314-7","volume":"42","author":"H Rakugi","year":"2019","unstructured":"Rakugi H, Ito S, Itoh H, Okuda Y, Yamakawa S. Long-term phase 3 study of Esaxerenone as mono or combination therapy with other antihypertensive drugs in patients with essential hypertension. Hypertens Res. 2019;42(12):1932\u201341.","journal-title":"Hypertens Res"},{"issue":"1","key":"740_CR19","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1097\/FJC.0000000000000091","volume":"64","author":"P Kolkhof","year":"2014","unstructured":"Kolkhof P, Delbeck M, Kretschmer A, Steinke W, Hartmann E, B\u00e4rfacker L, et al. Finerenone, a novel selective nonsteroidal mineralocorticoid receptor antagonist protects from rat cardiorenal injury. J Cardiovasc Pharmacol. 2014;64(1):69\u201378.","journal-title":"J Cardiovasc Pharmacol"},{"key":"740_CR20","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.coph.2016.02.005","volume":"27","author":"J Yang","year":"2016","unstructured":"Yang J, Young MJ. Mineralocorticoid receptor antagonists-pharmacodynamics and pharmacokinetic differences. Curr Opin Pharmacol. 2016;27:78\u201385.","journal-title":"Curr Opin Pharmacol"},{"issue":"9","key":"740_CR21","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1016\/S0895-7061(03)00913-0","volume":"16","author":"A Sato","year":"2003","unstructured":"Sato A, Saruta T. Aldosterone breakthrough during angiotensin-converting enzyme inhibitor therapy. Am J Hypertens. 2003;16(9):781\u20138.","journal-title":"Am J Hypertens"},{"issue":"12","key":"740_CR22","doi-asserted-by":"publisher","first-page":"1329","DOI":"10.1016\/j.amjhyper.2007.09.001","volume":"20","author":"T Yoneda","year":"2007","unstructured":"Yoneda T, Takeda Y, Usukura M, Oda N, Takata H, Yamamoto Y, et al. Aldosterone breakthrough during angiotensin II receptor blockade in hypertensive patients with diabetes mellitus. Am J Hypertens. 2007;20(12):1329\u201333.","journal-title":"Am J Hypertens"},{"issue":"1","key":"740_CR23","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.kisu.2021.11.006","volume":"12","author":"JM Luther","year":"2022","unstructured":"Luther JM, Fogo AB. The role of mineralocorticoid receptor activation in kidney inflammation and fibrosis. Kidney Int Suppl (2011). 2022;12(1):63\u20138.","journal-title":"Kidney Int Suppl (2011)"},{"issue":"1","key":"740_CR24","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1161\/HYPERTENSIONAHA.116.07716","volume":"69","author":"K Bogman","year":"2017","unstructured":"Bogman K, Schwab D, Delporte ML, Palermo G, Amrein K, Mohr S, et al. Preclinical and early clinical profile of a highly selective and potent oral inhibitor of aldosterone synthase (CYP11B2). Hypertension. 2017;69(1):189\u201396.","journal-title":"Hypertension"},{"issue":"5","key":"740_CR25","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1056\/NEJMoa2213169","volume":"388","author":"MW Freeman","year":"2023","unstructured":"Freeman MW, Halvorsen YD, Marshall W, Pater M, Isaacsohn J, Pearce C, et al. Phase 2 trial of Baxdrostat for treatment-resistant hypertension. N Engl J Med. 2023;388(5):395\u2013405.","journal-title":"N Engl J Med"},{"issue":"6","key":"740_CR26","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.1093\/ndt\/gfae263","volume":"40","author":"PK Judge","year":"2024","unstructured":"Judge PK, Tuttle KR, Staplin N, Hauske SJ, Zhu D, Sardell R, et al. The potential for improving cardio-renal outcomes in chronic kidney disease with the aldosterone synthase inhibitor vicadrostat (BI 690517): a rationale for the EASi-KIDNEY trial. Nephrol Dial Transplant. 2024;40(6):1175\u201386.","journal-title":"Nephrol Dial Transplant"},{"issue":"3","key":"740_CR27","doi-asserted-by":"publisher","first-page":"H670","DOI":"10.1152\/ajpheart.00419.2023","volume":"326","author":"S Verma","year":"2024","unstructured":"Verma S, Pandey A, Pandey AK, Butler J, Lee JS, Teoh H, et al. Aldosterone and aldosterone synthase inhibitors in cardiorenal disease. Am J Physiol Heart Circ Physiol. 2024;326(3):H670-h88.","journal-title":"Am J Physiol Heart Circ Physiol"},{"issue":"5","key":"740_CR28","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.cardfail.2022.02.010","volume":"28","author":"2022 AHA\/ACC\/HFSA Guideline for the Management of Heart Failure","year":"2022","unstructured":"2022 AHA\/ACC\/HFSA Guideline for the Management of Heart Failure. J Card Fail. 2022;28(5):e1\u2013167.","journal-title":"J Card Fail"},{"issue":"36","key":"740_CR29","doi-asserted-by":"publisher","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","volume":"42","author":"TA McDonagh","year":"2021","unstructured":"McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, B\u00f6hm M, et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European society of cardiology (ESC) with the special contribution of the heart failure association (HFA) of the ESC. Eur Heart J. 2021;42(36):3599\u2013726.","journal-title":"Eur Heart J"},{"issue":"15","key":"740_CR30","doi-asserted-by":"publisher","first-page":"1383","DOI":"10.1056\/NEJMoa1313731","volume":"370","author":"B Pitt","year":"2014","unstructured":"Pitt B, Pfeffer MA, Assmann SF, Boineau R, Anand IS, Claggett B, et al. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med. 2014;370(15):1383\u201392.","journal-title":"N Engl J Med"},{"issue":"1","key":"740_CR31","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1161\/CIRCULATIONAHA.114.013255","volume":"131","author":"MA Pfeffer","year":"2015","unstructured":"Pfeffer MA, Claggett B, Assmann SF, Boineau R, Anand IS, Clausell N, et al. Regional variation in patients and outcomes in the treatment of preserved cardiac function heart failure with an aldosterone antagonist (TOPCAT) trial. Circulation. 2015;131(1):34\u201342.","journal-title":"Circulation"},{"issue":"3","key":"740_CR32","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1016\/j.jacbts.2016.03.001","volume":"1","author":"MR Bristow","year":"2016","unstructured":"Bristow MR, Enciso JS, Gersh BJ, Grady C, Rice MM, Singh S, et al. Detection and management of geographic disparities in the TOPCAT trial: lessons learned and derivative recommendations. JACC Basic Transl Sci. 2016;1(3):180\u20139.","journal-title":"JACC Basic Transl Sci"},{"issue":"1","key":"740_CR33","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDctcs2100007","volume":"1","author":"MA Pfeffer","year":"2022","unstructured":"Pfeffer MA, Claggett B. Behind the scenes of TOPCAT - bending to inform. NEJM Evid. 2022;1(1):EVIDctcs2100007.","journal-title":"NEJM Evid"},{"issue":"17","key":"740_CR34","doi-asserted-by":"publisher","first-page":"1690","DOI":"10.1056\/NEJMc1612601","volume":"376","author":"S de Denus","year":"2017","unstructured":"de Denus S, O\u2019Meara E, Desai AS, Claggett B, Lewis EF, Leclair G, et al. Spironolactone metabolites in TOPCAT - New insights into regional variation. N Engl J Med. 2017;376(17):1690\u20132.","journal-title":"N Engl J Med"},{"issue":"5","key":"740_CR35","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1093\/eurheartj\/ehv464","volume":"37","author":"SD Solomon","year":"2015","unstructured":"Solomon SD, Claggett B, Lewis EF, Desai A, Anand I, Sweitzer NK, et al. Influence of ejection fraction on outcomes and efficacy of spironolactone in patients with heart failure with preserved ejection fraction. Eur Heart J. 2015;37(5):455\u201362.","journal-title":"Eur Heart J"},{"issue":"5","key":"740_CR36","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1016\/j.jacc.2025.05.033","volume":"86","author":"JP Ferreira","year":"2025","unstructured":"Ferreira JP, Vasques-N\u00f3voa F, Saraiva F, Oliveira AC, Almeida J, Batista AB, et al. Sodium-glucose cotransporter 2 inhibitor with and without an aldosterone antagonist for heart failure with preserved ejection fraction. J Am Coll Cardiol. 2025;86(5):320\u201333.","journal-title":"J Am Coll Cardiol"},{"issue":"9","key":"740_CR37","doi-asserted-by":"publisher","first-page":"2086","DOI":"10.1016\/j.clinthera.2015.05.508","volume":"37","author":"J Hou","year":"2015","unstructured":"Hou J, Xiong W, Cao L, Wen X, Li A. Spironolactone add-on for preventing or slowing the progression of diabetic nephropathy: a meta-analysis. Clin Ther. 2015;37(9):2086-103.e10.","journal-title":"Clin Ther"},{"issue":"12","key":"740_CR38","doi-asserted-by":"publisher","first-page":"3634","DOI":"10.1038\/s41591-024-03263-5","volume":"30","author":"FDR Hobbs","year":"2024","unstructured":"Hobbs FDR, McManus RJ, Taylor CJ, Jones NR, Rahman JK, Wolstenholme J, et al. Low-dose spironolactone and cardiovascular outcomes in moderate stage chronic kidney disease: a randomized controlled trial. Nat Med. 2024;30(12):3634\u201345.","journal-title":"Nat Med"},{"issue":"4","key":"740_CR39","doi-asserted-by":"publisher","first-page":"1270","DOI":"10.1046\/j.1523-1755.2000.00961.x","volume":"57","author":"H Garty","year":"2000","unstructured":"Garty H. Regulation of the epithelial Na\u2009+\u2009channel by aldosterone: open questions and emerging answers. Kidney Int. 2000;57(4):1270\u20136.","journal-title":"Kidney Int"},{"issue":"6","key":"740_CR40","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1056\/NEJMoa040135","volume":"351","author":"DN Juurlink","year":"2004","unstructured":"Juurlink DN, Mamdani MM, Lee DS, Kopp A, Austin PC, Laupacis A, et al. Rates of hyperkalemia after publication of the randomized aldactone evaluation study. N Engl J Med. 2004;351(6):543\u201351.","journal-title":"N Engl J Med"},{"issue":"3","key":"740_CR41","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1016\/j.cardfail.2006.01.003","volume":"12","author":"DT Ko","year":"2006","unstructured":"Ko DT, Juurlink DN, Mamdani MM, You JJ, Wang JT, Donovan LR, et al. Appropriateness of spironolactone prescribing in heart failure patients: a population-based study. J Card Fail. 2006;12(3):205\u201310.","journal-title":"J Card Fail"},{"key":"740_CR42","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c1768","volume":"340","author":"L Wei","year":"2010","unstructured":"Wei L, Struthers AD, Fahey T, Watson AD, Macdonald TM. Spironolactone use and renal toxicity: population based longitudinal analysis. BMJ. 2010;340:c1768.","journal-title":"BMJ"},{"issue":"1","key":"740_CR43","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1001\/jamacardio.2016.4733","volume":"2","author":"AS Desai","year":"2017","unstructured":"Desai AS, Vardeny O, Claggett B, McMurray JJV, Packer M, Swedberg K, et al. Reduced risk of hyperkalemia during treatment of heart failure with mineralocorticoid receptor antagonists by use of Sacubitril\/Valsartan compared with enalapril: A secondary analysis of the PARADIGM-HF trial. JAMA Cardiol. 2017;2(1):79\u201385.","journal-title":"JAMA Cardiol"},{"issue":"19","key":"740_CR44","doi-asserted-by":"publisher","first-page":"1460","DOI":"10.1161\/CIRCULATIONAHA.121.057736","volume":"145","author":"BL Neuen","year":"2022","unstructured":"Neuen BL, Oshima M, Agarwal R, Arnott C, Cherney DZ, Edwards R, et al. Sodium-glucose cotransporter 2 inhibitors and risk of hyperkalemia in people with type 2 diabetes: a meta-analysis of individual participant data from randomized, controlled trials. Circulation. 2022;145(19):1460\u201370.","journal-title":"Circulation"},{"issue":"8","key":"740_CR45","doi-asserted-by":"publisher","first-page":"1569","DOI":"10.1681\/ASN.2022020207","volume":"33","author":"M Provenzano","year":"2022","unstructured":"Provenzano M, Puchades MJ, Garofalo C, Jongs N, D\u2019Marco L, Andreucci M, et al. Albuminuria-Lowering effect of Dapagliflozin, Eplerenone, and their combination in patients with chronic kidney disease: A randomized crossover clinical trial. J Am Soc Nephrol. 2022;33(8):1569\u201380.","journal-title":"J Am Soc Nephrol"},{"issue":"1","key":"740_CR46","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000534366","volume":"55","author":"C-Y Yuan","year":"2023","unstructured":"Yuan C-Y, Gao Y-C, Lin Y, Liu L, Shen X-G, Zou W-L, et al. Effects of mineralocorticoid receptor antagonists for chronic kidney disease: a systemic review and meta-analysis. Am J Nephrol. 2023;55(1):1\u201317.","journal-title":"Am J Nephrol"},{"issue":"20","key":"740_CR47","doi-asserted-by":"publisher","first-page":"2082","DOI":"10.1016\/j.jacc.2012.07.048","volume":"60","author":"O Vardeny","year":"2012","unstructured":"Vardeny O, Wu DH, Desai A, Rossignol P, Zannad F, Pitt B, et al. Influence of baseline and worsening renal function on efficacy of spironolactone in patients with severe heart failure. JACC. 2012;60(20):2082\u20139.","journal-title":"JACC"},{"issue":"3","key":"740_CR48","first-page":"188","volume":"8","author":"M Serenelli","year":"2020","unstructured":"Serenelli M, Jackson A, Dewan P, Jhund PS, Petrie MC, Rossignol P, et al. Mineralocorticoid receptor antagonists, blood pressure, and outcomes in heart failure with reduced ejection fraction. JACC: Heart Failure. 2020;8(3):188\u201398.","journal-title":"JACC: Heart Failure"},{"issue":"12","key":"740_CR49","doi-asserted-by":"publisher","first-page":"2164","DOI":"10.1002\/ejhf.3049","volume":"25","author":"F Guidetti","year":"2023","unstructured":"Guidetti F, Lund LH, Benson L, Hage C, Musella F, Stolfo D, et al. Safety of continuing mineralocorticoid receptor antagonist treatment in patients with heart failure with reduced ejection fraction and severe kidney disease: data from Swedish Heart Failure Registry. Eur J Heart Fail. 2023;25(12):2164\u201373.","journal-title":"Eur J Heart Fail"},{"issue":"4","key":"740_CR50","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1016\/j.jacc.2018.04.070","volume":"72","author":"SJ Greene","year":"2018","unstructured":"Greene SJ, Butler J, Albert NM, DeVore AD, Sharma PP, Duffy CI, et al. Medical therapy for heart failure with reduced ejection fraction. J Am Coll Cardiol. 2018;72(4):351\u201366.","journal-title":"J Am Coll Cardiol"},{"issue":"1","key":"740_CR51","first-page":"1","volume":"11","author":"G Savarese","year":"2023","unstructured":"Savarese G, Kishi T, Vardeny O, Eryd SA, Bodeg\u00e5rd J, Lund LH, et al. Heart failure drug treatment\u2014inertia, titration, and discontinuation. JACC: Heart Failure. 2023;11(1):1\u201314.","journal-title":"JACC: Heart Failure"},{"issue":"27","key":"740_CR52","doi-asserted-by":"publisher","first-page":"2105","DOI":"10.1093\/eurheartj\/ehw132","volume":"37","author":"G Filippatos","year":"2016","unstructured":"Filippatos G, Anker SD, B\u00f6hm M, Gheorghiade M, K\u00f8ber L, Krum H, et al. A randomized controlled study of finerenone vs. eplerenone in patients with worsening chronic heart failure and diabetes mellitus and\/or chronic kidney disease. Eur Heart J. 2016;37(27):2105\u201314.","journal-title":"Eur Heart J"},{"issue":"6","key":"740_CR53","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1002\/ejhf.2469","volume":"24","author":"G Filippatos","year":"2022","unstructured":"Filippatos G, Pitt B, Agarwal R, Farmakis D, Ruilope LM, Rossing P, et al. Finerenone in patients with chronic kidney disease and type 2 diabetes with and without heart failure: a prespecified subgroup analysis of the FIDELIO-DKD trial. Eur J Heart Fail. 2022;24(6):996\u20131005.","journal-title":"Eur J Heart Fail"},{"issue":"6","key":"740_CR54","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1161\/CIRCULATIONAHA.121.057983","volume":"145","author":"G Filippatos","year":"2022","unstructured":"Filippatos G, Anker SD, Agarwal R, Ruilope LM, Rossing P, Bakris GL, et al. Finerenone reduces risk of incident heart failure in patients with chronic kidney disease and type 2 diabetes: analyses from the FIGARO-DKD trial. Circulation. 2022;145(6):437\u201347.","journal-title":"Circulation"},{"issue":"16","key":"740_CR55","doi-asserted-by":"publisher","first-page":"1475","DOI":"10.1056\/NEJMoa2407107","volume":"391","author":"SD Solomon","year":"2024","unstructured":"Solomon SD, McMurray JJV, Vaduganathan M, Claggett B, Jhund PS, Desai AS, et al. Finerenone in heart failure with mildly reduced or preserved ejection fraction. N Engl J Med. 2024;391(16):1475\u201385.","journal-title":"N Engl J Med"},{"issue":"2","key":"740_CR56","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1161\/CIRCULATIONAHA.124.072055","volume":"151","author":"M Vaduganathan","year":"2025","unstructured":"Vaduganathan M, Claggett BL, Kulac IJ, Miao ZM, Desai AS, Jhund PS, et al. Effects of the nonsteroidal MRA finerenone with and without concomitant SGLT2 inhibitor use in heart failure. Circulation. 2025;151(2):149\u201358.","journal-title":"Circulation"},{"issue":"2","key":"740_CR57","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1093\/ndt\/gfac157","volume":"38","author":"LM Ruilope","year":"2023","unstructured":"Ruilope LM, Pitt B, Anker SD, Rossing P, Kovesdy CP, Pecoits-Filho R, et al. Kidney outcomes with finerenone: an analysis from the FIGARO-DKD study. Nephrol Dial Transpl. 2023;38(2):372\u201383.","journal-title":"Nephrol Dial Transpl"},{"issue":"6","key":"740_CR58","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1093\/eurheartj\/ehab777","volume":"43","author":"R Agarwal","year":"2022","unstructured":"Agarwal R, Filippatos G, Pitt B, Anker SD, Rossing P, Joseph A, et al. Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis. Eur Heart J. 2022;43(6):474\u201384.","journal-title":"Eur Heart J"},{"key":"740_CR59","doi-asserted-by":"crossref","unstructured":"KDIGO. 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney Int. 2022;102(5s):S1-s127.","DOI":"10.1016\/j.kint.2022.06.008"},{"issue":"12","key":"740_CR60","doi-asserted-by":"publisher","first-page":"3075","DOI":"10.2337\/dci22-0027","volume":"45","author":"IH de Boer","year":"2022","unstructured":"de Boer IH, Khunti K, Sadusky T, Tuttle KR, Neumiller JJ, Rhee CM, et al. Diabetes management in chronic kidney disease: a consensus report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO). Diabetes Care. 2022;45(12):3075\u201390.","journal-title":"Diabetes Care"},{"issue":"1","key":"740_CR61","doi-asserted-by":"publisher","first-page":"2","DOI":"10.17925\/EE.2023.19.1.2","volume":"19","author":"S Bhattacharya","year":"2023","unstructured":"Bhattacharya S, Kalra S. The AACE 2022 guideline: an academic appraisal. TouchREV Endocrinol. 2023;19(1):2\u20133.","journal-title":"TouchREV Endocrinol"},{"issue":"39","key":"740_CR62","doi-asserted-by":"publisher","first-page":"4043","DOI":"10.1093\/eurheartj\/ehad192","volume":"44","author":"N Marx","year":"2023","unstructured":"Marx N, Federici M, Sch\u00fctt K, M\u00fcller-Wieland D, Ajjan RA, Antunes MJ, et al. 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes: developed by the task force on the management of cardiovascular disease in patients with diabetes of the European society of cardiology (ESC). Eur Heart J. 2023;44(39):4043\u2013140.","journal-title":"Eur Heart J"},{"issue":"Supplement1","key":"740_CR63","first-page":"S191","volume":"46","author":"NA ElSayed","year":"2022","unstructured":"ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 11. Chronic kidney disease and risk management: standards of care in Diabetes\u20142023. Diabetes Care. 2022;46(Supplement1):S191\u2013202.","journal-title":"Diabetes Care"},{"key":"740_CR64","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2410659","author":"R Agarwal","year":"2025","unstructured":"Agarwal R, Green JB, Heerspink HJL, Mann JFE, McGill JB, Mottl AK, et al. Finerenone with empagliflozin in chronic kidney disease and type 2 diabetes. N Engl J Med. 2025. https:\/\/doi.org\/10.1056\/NEJMoa2410659.","journal-title":"N Engl J Med"},{"issue":"12","key":"740_CR65","doi-asserted-by":"publisher","first-page":"1715","DOI":"10.2215\/CJN.06870520","volume":"15","author":"S Ito","year":"2020","unstructured":"Ito S, Kashihara N, Shikata K, Nangaku M, Wada T, Okuda Y, et al. Esaxerenone (CS-3150) in patients with type 2 diabetes and microalbuminuria (ESAX-DN): phase 3 randomized controlled clinical trial. Clin J Am Soc Nephrol. 2020;15(12):1715\u201327.","journal-title":"Clin J Am Soc Nephrol"},{"key":"740_CR66","doi-asserted-by":"publisher","DOI":"10.3390\/life15050741","author":"A Sezai","year":"2025","unstructured":"Sezai A, Abe M, Maruyama T, Taoka M, Sekino H, Tanaka M. A prospective crossover clinical trial of esaxerenone and eplerenone in patients with chronic heart failure complicated by hypertension. Life. 2025. https:\/\/doi.org\/10.3390\/life15050741.","journal-title":"Life"},{"issue":"8","key":"740_CR67","doi-asserted-by":"publisher","first-page":"1727","DOI":"10.1002\/ejhf.3294","volume":"26","author":"CSP Lam","year":"2024","unstructured":"Lam CSP, K\u00f8ber L, Kuwahara K, Lund LH, Mark PB, Mellbin LG, et al. Balcinrenone plus dapagliflozin in patients with heart failure and chronic kidney disease: results from the phase 2b MIRACLE trial. Eur J Heart Fail. 2024;26(8):1727\u201335.","journal-title":"Eur J Heart Fail"},{"issue":"2","key":"740_CR68","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1007\/s10157-020-01963-z","volume":"25","author":"T Wada","year":"2021","unstructured":"Wada T, Inagaki M, Yoshinari T, Terata R, Totsuka N, Gotou M, et al. Apararenone in patients with diabetic nephropathy: results of a randomized, double-blind, placebo-controlled phase 2 dose-response study and open-label extension study. Clin Exp Nephrol. 2021;25(2):120\u201330.","journal-title":"Clin Exp Nephrol"},{"key":"740_CR69","doi-asserted-by":"crossref","unstructured":"Ramadan MM, Alajmi S, Aldouseri J, Alajmi M, Tello EA, Mahdi A-MO et al. Pharmacology and therapeutic potential of finerenone: A novel Third-Generation nonsteroidal mineralocorticoid receptor antagonist. Cureus. 2025;17(7).","DOI":"10.7759\/cureus.87706"},{"issue":"7","key":"740_CR70","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1038\/s41371-019-0207-x","volume":"33","author":"S Ito","year":"2019","unstructured":"Ito S, Itoh H, Rakugi H, Okuda Y, Yamakawa S. Efficacy and safety of esaxerenone (CS-3150) for the treatment of essential hypertension: a phase 2 randomized, placebo-controlled, double-blind study. J Hum Hypertens. 2019;33(7):542\u201351.","journal-title":"J Hum Hypertens"},{"issue":"12","key":"740_CR71","doi-asserted-by":"publisher","first-page":"1140","DOI":"10.1001\/jama.2023.16029","volume":"330","author":"LJ Laffin","year":"2023","unstructured":"Laffin LJ, Rodman D, Luther JM, Vaidya A, Weir MR, Rajicic N, et al. Aldosterone synthase Inhibition with Lorundrostat for uncontrolled hypertension: the Target-HTN randomized clinical trial. JAMA. 2023;330(12):1140\u201350.","journal-title":"JAMA"},{"issue":"18","key":"740_CR72","doi-asserted-by":"publisher","first-page":"1813","DOI":"10.1056\/NEJMoa2501440","volume":"392","author":"LJ Laffin","year":"2025","unstructured":"Laffin LJ, Kopjar B, Melgaard C, Wolski K, Ibbitson J, Bhikam S, et al. Lorundrostat efficacy and safety in patients with uncontrolled hypertension. N Engl J Med. 2025;392(18):1813\u201323.","journal-title":"N Engl J Med"},{"issue":"8","key":"740_CR73","doi-asserted-by":"publisher","first-page":"2483","DOI":"10.1111\/bcp.15713","volume":"89","author":"P Mulatero","year":"2023","unstructured":"Mulatero P, Groessl M, Vogt B, Schumacher C, Steele RE, Brooks A, et al. CYP11B2 inhibitor dexfadrostat phosphate suppresses the aldosterone-to-renin ratio, an indicator of sodium retention, in healthy volunteers. Br J Clin Pharmacol. 2023;89(8):2483\u201396.","journal-title":"Br J Clin Pharmacol"},{"issue":"10424","key":"740_CR74","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1016\/S0140-6736(23)02408-X","volume":"403","author":"KR Tuttle","year":"2024","unstructured":"Tuttle KR, Hauske SJ, Canziani ME, Caramori ML, Cherney D, Cronin L, et al. Efficacy and safety of aldosterone synthase Inhibition with and without empagliflozin for chronic kidney disease: a randomised, controlled, phase 2 trial. Lancet. 2024;403(10424):379\u201390.","journal-title":"Lancet"}],"container-title":["Current Heart Failure Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11897-026-00740-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11897-026-00740-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11897-026-00740-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T08:02:53Z","timestamp":1769760173000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11897-026-00740-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,30]]},"references-count":74,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["740"],"URL":"https:\/\/doi.org\/10.1007\/s11897-026-00740-5","relation":{},"ISSN":["1546-9549"],"issn-type":[{"value":"1546-9549","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,30]]},"assertion":[{"value":"2 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"5"}}