{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:52:29Z","timestamp":1793321549144,"version":"4.5.0"},"reference-count":53,"publisher":"Elsevier BV","issue":"9","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T00:00:00Z","timestamp":1621987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5 R01 HL126903"],"award-info":[{"award-number":["5 R01 HL126903"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["kireports.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Kidney International Reports"],"published-print":{"date-parts":[[2021,9]]},"DOI":"10.1016\/j.ekir.2021.05.027","type":"journal-article","created":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T22:27:28Z","timestamp":1623277648000},"page":"2281-2291","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":74,"title":["Mineralocorticoid Receptor Antagonism in Chronic Kidney Disease"],"prefix":"10.1016","volume":"6","author":[{"given":"Panagiotis I.","family":"Georgianos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv","family":"Agarwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ekir.2021.05.027_bib1","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1093\/eurheartj\/ehaa736","article-title":"Steroidal and non-steroidal mineralocorticoid receptor antagonists in cardiorenal medicine","volume":"42","author":"Agarwal","year":"2021","journal-title":"Eur Heart J"},{"key":"10.1016\/j.ekir.2021.05.027_bib2","article-title":"Investigating new treatment opportunities for patients with chronic kidney disease in type 2 diabetes: the role of finerenone [Online ahead of print]","author":"Agarwal","year":"2020","journal-title":"Nephrol Dial Transplant"},{"key":"10.1016\/j.ekir.2021.05.027_bib3","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1056\/NEJM199909023411001","article-title":"The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators","volume":"341","author":"Pitt","year":"1999","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.ekir.2021.05.027_bib4","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1056\/NEJMoa030207","article-title":"Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction","volume":"348","author":"Pitt","year":"2003","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.ekir.2021.05.027_bib5","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1002\/ejhf.592","volume":"18","author":"Ponikowski","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"10.1016\/j.ekir.2021.05.027_bib6","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1002\/ejhf.1182","article-title":"Factors associated with underuse of mineralocorticoid receptor antagonists in heart failure with reduced ejection fraction: an analysis of 11,215 patients from the Swedish Heart Failure Registry","volume":"20","author":"Savarese","year":"2018","journal-title":"Eur J Heart Fail"},{"key":"10.1016\/j.ekir.2021.05.027_bib7","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.kint.2017.08.038","article-title":"Revisiting RAAS blockade in CKD with newer potassium-binding drugs","volume":"93","author":"Georgianos","year":"2018","journal-title":"Kidney Int"},{"key":"10.1016\/j.ekir.2021.05.027_bib8","doi-asserted-by":"crossref","first-page":"e53","DOI":"10.1161\/HYP.0000000000000084","article-title":"Resistant hypertension: detection, evaluation, and management: a scientific statement from the American Heart Association","volume":"72","author":"Carey","year":"2018","journal-title":"Hypertension"},{"key":"10.1016\/j.ekir.2021.05.027_bib9","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1097\/HJH.0000000000001940","article-title":"2018 ESC\/ESH guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension","volume":"36","author":"Williams","year":"2018","journal-title":"J\u00a0Hypertens"},{"key":"10.1016\/j.ekir.2021.05.027_bib10","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.2215\/CJN.00550113","article-title":"Prevalence of apparent treatment-resistant hypertension among individuals with CKD","volume":"8","author":"Tanner","year":"2013","journal-title":"Clin J Am Soc Nephrol"},{"key":"10.1016\/j.ekir.2021.05.027_bib11","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1161\/HYPERTENSIONAHA.115.06487","article-title":"Prevalence and prognostic significance of apparent treatment resistant hypertension in chronic kidney disease: report from the Chronic Renal Insufficiency Cohort Study","volume":"67","author":"Thomas","year":"2016","journal-title":"Hypertension"},{"key":"10.1016\/j.ekir.2021.05.027_bib12","doi-asserted-by":"crossref","first-page":"2219","DOI":"10.1056\/NEJMoa2025845","article-title":"Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes","volume":"383","author":"Bakris","year":"2020","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.ekir.2021.05.027_bib13","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1093\/ndt\/gfx312","article-title":"Elevated potassium levels in patients with chronic kidney disease: occurrence, risk factors and clinical outcomes-a Danish population-based cohort study","volume":"33","author":"Thomsen","year":"2018","journal-title":"Nephrol Dial Transplant"},{"key":"10.1016\/j.ekir.2021.05.027_bib14","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1007\/s11906-020-01081-x","article-title":"Resistant hypertension in chronic kidney disease (CKD): prevalence, treatment particularities, and research agenda","volume":"22","author":"Georgianos","year":"2020","journal-title":"Curr Hypertens Rep"},{"key":"10.1016\/j.ekir.2021.05.027_bib15","first-page":"S212","article-title":"Evaluation of the treatment gap between clinical guidelines and the utilization of renin-angiotensin-aldosterone system inhibitors","volume":"21","author":"Epstein","year":"2015","journal-title":"Am J Manag Care"},{"key":"10.1016\/j.ekir.2021.05.027_bib16","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1016\/j.kint.2017.12.016","article-title":"The myeloid mineralocorticoid receptor controls inflammatory and fibrotic responses after renal injury via macrophage interleukin-4 receptor signaling","volume":"93","author":"Barrera-Chimal","year":"2018","journal-title":"Kidney Int"},{"key":"10.1016\/j.ekir.2021.05.027_bib17","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.3389\/fphar.2018.01131","article-title":"Finerenone attenuates endothelial dysfunction and albuminuria in a chronic kidney disease model by a reduction in oxidative stress","volume":"9","author":"Gonzalez-Blazquez","year":"2018","journal-title":"Front Pharmacol"},{"key":"10.1016\/j.ekir.2021.05.027_bib18","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1161\/HYPERTENSIONAHA.117.10360","article-title":"Selective mineralocorticoid receptor cofactor modulation as molecular basis for finerenone's antifibrotic activity","volume":"71","author":"Grune","year":"2018","journal-title":"Hypertension"},{"key":"10.1016\/j.ekir.2021.05.027_bib19","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1001\/jama.2015.10081","article-title":"Effect of finerenone on albuminuria in patients with diabetic nephropathy: a randomized clinical trial","volume":"314","author":"Bakris","year":"2015","journal-title":"JAMA"},{"key":"10.1016\/j.ekir.2021.05.027_bib20","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1093\/eurheartj\/ehw132","article-title":"A\u00a0randomized controlled study of finerenone vs. eplerenone in patients with worsening chronic heart failure and diabetes mellitus and\/or chronic kidney disease","volume":"37","author":"Filippatos","year":"2016","journal-title":"Eur Heart J"},{"key":"10.1016\/j.ekir.2021.05.027_bib21","doi-asserted-by":"crossref","first-page":"2453","DOI":"10.1093\/eurheartj\/eht187","article-title":"Safety and tolerability of the novel non-steroidal mineralocorticoid receptor antagonist BAY 94-8862 in patients with chronic heart failure and mild or moderate chronic kidney disease: a randomized, double-blind trial","volume":"34","author":"Pitt","year":"2013","journal-title":"Eur Heart J"},{"key":"10.1016\/j.ekir.2021.05.027_bib22","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1038\/ki.2011.505","article-title":"Aldosterone blockade and the mineralocorticoid receptor in the management of chronic kidney disease: current concepts and emerging treatment paradigms","volume":"81","author":"Shavit","year":"2012","journal-title":"Kidney Int"},{"issue":"4","key":"10.1016\/j.ekir.2021.05.027_bib23","first-page":"CD007004","article-title":"Aldosterone antagonists for preventing the progression of chronic kidney disease","author":"Bolignano","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"issue":"3","key":"10.1016\/j.ekir.2021.05.027_bib24","first-page":"CD007004","article-title":"Aldosterone antagonists for preventing the progression of chronic kidney disease","author":"Navaneethan","year":"2009","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.ekir.2021.05.027_bib25","first-page":"CD007004","article-title":"Aldosterone antagonists in addition to renin angiotensin system antagonists for preventing the progression of chronic kidney disease","volume":"10","author":"Chung","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.ekir.2021.05.027_bib26","doi-asserted-by":"crossref","first-page":"1892","DOI":"10.1056\/NEJMoa1303154","article-title":"Combined angiotensin inhibition for the treatment of diabetic nephropathy","volume":"369","author":"Fried","year":"2013","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.ekir.2021.05.027_bib27","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S0140-6736(08)61236-2","article-title":"Renal outcomes with telmisartan, ramipril, or both, in people at high vascular risk (the ONTARGET study): a multicentre, randomised, double-blind, controlled trial","volume":"372","author":"Mann","year":"2008","journal-title":"Lancet"},{"key":"10.1016\/j.ekir.2021.05.027_bib28","doi-asserted-by":"crossref","first-page":"2204","DOI":"10.1056\/NEJMoa1208799","article-title":"Cardiorenal end points in a trial of aliskiren for type 2 diabetes","volume":"367","author":"Parving","year":"2012","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.ekir.2021.05.027_bib29","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1053\/j.ajkd.2016.04.011","article-title":"The safety and efficacy of mineralocorticoid receptor antagonists in patients who require dialysis: a systematic review and meta-analysis","volume":"68","author":"Quach","year":"2016","journal-title":"Am J Kidney Dis"},{"key":"10.1016\/j.ekir.2021.05.027_bib30","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/j.kint.2018.08.034","article-title":"Safety and cardiovascular efficacy of spironolactone in dialysis-dependent ESRD (SPin-D): a randomized, placebo-controlled, multiple dosage trial","volume":"95","author":"Charytan","year":"2019","journal-title":"Kidney Int"},{"key":"10.1016\/j.ekir.2021.05.027_bib31","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/j.kint.2018.11.025","article-title":"A\u00a0randomized controlled trial of the effect of spironolactone on left ventricular mass in hemodialysis patients","volume":"95","author":"Hammer","year":"2019","journal-title":"Kidney Int"},{"key":"10.1016\/j.ekir.2021.05.027_bib32","first-page":"CD013109","article-title":"Aldosterone antagonists for people with chronic kidney disease requiring dialysis","volume":"2","author":"Hasegawa","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.ekir.2021.05.027_bib33","doi-asserted-by":"crossref","first-page":"599","DOI":"10.2174\/1570161115666170201113817","article-title":"Mineralocorticoid antagonists in ESRD: an overview of clinical trial evidence","volume":"15","author":"Georgianos","year":"2017","journal-title":"Curr Vasc Pharmacol"},{"key":"10.1016\/j.ekir.2021.05.027_bib34","doi-asserted-by":"crossref","first-page":"T125","DOI":"10.1530\/JOE-16-0600","article-title":"30 years of the mineralocorticoid receptor: mineralocorticoid receptor antagonists: 60 years of research and development","volume":"234","author":"Kolkhof","year":"2017","journal-title":"J\u00a0Endocrinol"},{"key":"10.1016\/j.ekir.2021.05.027_bib35","doi-asserted-by":"crossref","first-page":"21876","DOI":"10.1074\/jbc.M115.657957","article-title":"finerenone impedes aldosterone-dependent nuclear import of the mineralocorticoid receptor and prevents genomic recruitment of steroid receptor coactivator-1","volume":"290","author":"Amazit","year":"2015","journal-title":"J\u00a0Biol Chem"},{"key":"10.1016\/j.ekir.2021.05.027_bib36","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.mce.2011.06.025","article-title":"Molecular pharmacology of the mineralocorticoid receptor: prospects for novel therapeutics","volume":"350","author":"Kolkhof","year":"2012","journal-title":"Mol Cell Endocrinol"},{"key":"10.1016\/j.ekir.2021.05.027_bib37","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1097\/FJC.0000000000000091","article-title":"Finerenone, a novel selective nonsteroidal mineralocorticoid receptor antagonist protects from rat cardiorenal injury","volume":"64","author":"Kolkhof","year":"2014","journal-title":"J\u00a0Cardiovasc Pharmacol"},{"key":"10.1016\/j.ekir.2021.05.027_bib38","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/S0895-7061(02)02957-6","article-title":"Eplerenone, a selective aldosterone blocker, in mild-to-moderate hypertension","volume":"15","author":"Weinberger","year":"2002","journal-title":"Am J Hypertens"},{"key":"10.1016\/j.ekir.2021.05.027_bib39","first-page":"1801","article-title":"Studies on organ- and subcellular distribution of 3 H-spironolactone in animals","volume":"22","author":"Platt","year":"1972","journal-title":"Arzneimittelforschung"},{"key":"10.1016\/j.ekir.2021.05.027_bib40","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1124\/dmd.118.083337","article-title":"Biotransformation of finerenone, a novel nonsteroidal mineralocorticoid receptor antagonist, in dogs, rats, and humans, in\u00a0vivo and in\u00a0vitro","volume":"46","author":"Gerisch","year":"2018","journal-title":"Drug Metab Dispos"},{"key":"10.1016\/j.ekir.2021.05.027_bib41","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s40262-019-00820-x","article-title":"Population pharmacokinetic and exposure-response analysis of finerenone: insights based on phase IIb data and simulations to support dose selection for pivotal trials in type 2 diabetes with chronic kidney disease","volume":"59","author":"Snelder","year":"2020","journal-title":"Clin Pharmacokinet"},{"key":"10.1016\/j.ekir.2021.05.027_bib42","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1007\/s13318-018-0483-9","article-title":"Pharmacokinetics of the novel, selective, non-steroidal mineralocorticoid receptor antagonist finerenone in healthy volunteers: results from an absolute bioavailability study and drug-drug interaction studies in\u00a0vitro and in\u00a0vivo","volume":"43","author":"Heinig","year":"2018","journal-title":"Eur J Drug Metab Pharmacokinet"},{"key":"10.1016\/j.ekir.2021.05.027_bib43","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1007\/s13318-019-00547-x","article-title":"Pharmacokinetics of the novel nonsteroidal mineralocorticoid receptor antagonist finerenone (BAY 94-8862) in individuals with mild or moderate hepatic impairment","volume":"44","author":"Heinig","year":"2019","journal-title":"Eur J Drug Metab Pharmacokinet"},{"key":"10.1016\/j.ekir.2021.05.027_bib44","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1002\/j.1552-4604.1989.tb03339.x","article-title":"Spironolactone metabolism: steady-state serum levels of the sulfur-containing metabolites","volume":"29","author":"Gardiner","year":"1989","journal-title":"J\u00a0Clin Pharmacol"},{"key":"10.1016\/j.ekir.2021.05.027_bib45","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1159\/000492622","article-title":"Patiromer to enable spironolactone use in the treatment of patients with resistant hypertension and chronic kidney disease: rationale and design of the AMBER study","volume":"48","author":"Agarwal","year":"2018","journal-title":"Am J Nephrol"},{"key":"10.1016\/j.ekir.2021.05.027_bib46","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1097\/FJC.0000000000000366","article-title":"Steroidal and nonsteroidal mineralocorticoid receptor antagonists cause differential cardiac gene expression in pressure overload-induced cardiac hypertrophy","volume":"67","author":"Grune","year":"2016","journal-title":"J\u00a0Cardiovasc Pharmacol"},{"key":"10.1016\/j.ekir.2021.05.027_bib47","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1161\/HYPERTENSIONAHA.115.06709","article-title":"Vascular smooth muscle mineralocorticoid receptor contributes to coronary and left ventricular dysfunction after myocardial infarction","volume":"67","author":"Gueret","year":"2016","journal-title":"Hypertension"},{"key":"10.1016\/j.ekir.2021.05.027_bib48","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.bcp.2019.07.001","article-title":"The non-steroidal mineralocorticoid receptor antagonist finerenone prevents cardiac fibrotic remodeling","volume":"168","author":"Lavall","year":"2019","journal-title":"Biochem Pharmacol"},{"key":"10.1016\/j.ekir.2021.05.027_bib49","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1161\/HYPERTENSIONAHA.117.09791","article-title":"Aldosterone target NGAL (neutrophil gelatinase-associated lipocalin) is involved in cardiac remodeling after myocardial infarction through NFkappaB pathway","volume":"70","author":"Martinez-Martinez","year":"2017","journal-title":"Hypertension"},{"key":"10.1016\/j.ekir.2021.05.027_bib50","doi-asserted-by":"crossref","first-page":"115","DOI":"10.3389\/fphar.2013.00115","article-title":"PF-03882845, a non-steroidal mineralocorticoid receptor antagonist, prevents renal injury with reduced risk of hyperkalemia in an animal model of nephropathy","volume":"4","author":"Orena","year":"2013","journal-title":"Front Pharmacol"},{"key":"10.1016\/j.ekir.2021.05.027_bib51","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0145666","article-title":"Suppression of rapidly progressive mouse glomerulonephritis with the non-steroidal mineralocorticoid receptor antagonist BR-4628","volume":"10","author":"Ma","year":"2015","journal-title":"PLoS One"},{"key":"10.1016\/j.ekir.2021.05.027_bib52","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1159\/000503712","article-title":"Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial","volume":"50","author":"Ruilope","year":"2019","journal-title":"Am J Nephrol"},{"key":"10.1016\/j.ekir.2021.05.027_bib53","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.kint.2017.01.030","article-title":"Diabetes with early kidney involvement may shorten life expectancy by 16 years","volume":"92","author":"Wen","year":"2017","journal-title":"Kidney Int"}],"container-title":["Kidney International Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2468024921012109?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2468024921012109?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T03:36:32Z","timestamp":1762832192000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2468024921012109"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9]]},"references-count":53,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["S2468024921012109"],"URL":"https:\/\/doi.org\/10.1016\/j.ekir.2021.05.027","relation":{},"ISSN":["2468-0249"],"issn-type":[{"value":"2468-0249","type":"print"}],"subject":[],"published":{"date-parts":[[2021,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Mineralocorticoid Receptor Antagonism in Chronic Kidney Disease","name":"articletitle","label":"Article Title"},{"value":"Kidney International Reports","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ekir.2021.05.027","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 International Society of Nephrology. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}