{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T04:20:21Z","timestamp":1788841221782,"version":"build-2803163510"},"reference-count":49,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T00:00:00Z","timestamp":1715817600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82170847"],"award-info":[{"award-number":["82170847"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Asians bear a heavier burden of chronic kidney disease (CKD), a common comorbidity of type 2 diabetes mellitus (T2DM), than non\u2010Asians. Nonsteroidal mineralocorticoid receptor antagonists (MRAs) have garnered attention for their potential advantages in renal outcomes. Nevertheless, the impact on diverse ethnic groups remains unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang database, and clinical trial registries were searched through August 2023 with the following keywords: nonsteroidal MRAs (finerenone, apararenone, esaxerenone, AZD9977, KBP\u20105074), CKD, T2DM, and randomized controlled trial (RCT). A random effects model was used to calculate overall effect sizes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seven RCTs with 14\u2009997 participants were enrolled. Nonsteroidal MRAs reduced urinary albumin to creatinine ratio (UACR) significantly more in Asians than non\u2010Asians: (weighted mean difference [WMD], \u22120.59, 95% CI, \u22120.73 to \u22120.45, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01) vs (WMD, \u22120.29, 95% CI, \u22120.32 to \u22120.27, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01), respectively. The average decline of estimated glomerular filtration rate (eGFR) was similar in Asians and non\u2010Asians (<jats:italic>p<\/jats:italic>\u2009&gt;\u2009.05). Regarding systolic blood pressure (SBP), nonsteroidal MRAs had a better antihypertension performance in Asians (WMD, \u22125.12, 95% CI, \u22125.84 to \u22124.41, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01) compared to non\u2010Asians (WMD, \u22123.64, 95% CI, \u22124.38 to \u22122.89, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01). A higher incidence of hyperkalemia and eGFR decrease \u226530% was found in Asians than non\u2010Asians (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Nonsteroidal MRAs exhibited significant renal benefits by decreasing UACR and lowering SBP in Asian than that of non\u2010Asian patients with CKD and T2DM, without increase of adverse events except hyperkalemia and eGFR decrease \u226530%.<\/jats:p><jats:p><jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/jdb13566-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/1753-0407.13566","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T17:35:31Z","timestamp":1715880931000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Renal effects and safety between Asian and <scp>non\u2010Asian<\/scp> chronic kidney disease and type 2 diabetes treated with nonsteroidal mineralocorticoid antagonists"],"prefix":"10.1111","volume":"16","author":[{"given":"Xiaoming","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabology, Shandong Provincial Qianfoshan Hospital Shandong University  Jinan China"},{"name":"Department of Endocrinology and Metabology The First Affiliated Hospital of Shandong First Medical University &amp; Shandong Provincial Qianfoshan Hospital  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabology, Shandong Provincial Qianfoshan Hospital Shandong University  Jinan China"},{"name":"Department of Endocrinology and Metabology The First Affiliated Hospital of Shandong First Medical University &amp; Shandong Provincial Qianfoshan Hospital  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuying","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabology The First Affiliated Hospital of Shandong First Medical University &amp; Shandong Provincial Qianfoshan Hospital  Jinan China"},{"name":"First Clinical Medical College Shandong University of Traditional Chinese Medicine  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pingjiang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabology The First Affiliated Hospital of Shandong First Medical University &amp; Shandong Provincial Qianfoshan Hospital  Jinan China"},{"name":"Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjun","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Qilu Hospital of Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0278-4879","authenticated-orcid":false,"given":"Lin","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabology, Shandong Provincial Qianfoshan Hospital Shandong University  Jinan China"},{"name":"Department of Endocrinology and Metabology The First Affiliated Hospital of Shandong First Medical University &amp; Shandong Provincial Qianfoshan Hospital  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/414782a"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574\u2010022\u201000669\u20104"},{"key":"e_1_2_9_4_1","volume-title":"IDF Diabetes Atlas","author":"Magliano 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