Table 9. Comparisons of MRA and ENaC Inhibitors* Drug Typical starting dose in PA Possible maximum dose in PA**** Usual cost Spironolactone 12.5–25 mg/d 200 mg/d $ Eplerenone 25–50 mg bid 200 mg bid $$–$$$ Finerenone** Unknown; 10–20 mg/d unknown $$$$ Amiloride 5–10 mg/d 40 mg/d $ Triamterene*** 50–100 mg/d 300 mg/d $

2020年12月19日 · 腎臓の遠位尿細管～皮質集合管には，アルドステロン依存性にはたらく上皮性ナトリウムチャネル（ENaC）があります． ENaCにアルドステロンが作用すると，カリウム排泄を促進し，ナトリウム（と水）の排泄を抑制します． ゆえに，Na-K交感系とも呼ばれます．

2024年1月11日 · PA has clear targeted treatment options including medical therapy with MR antagonist (MRA) or adrenalectomy in the case of an aldosterone-producing adenoma. Importantly, adrenalectomy to remove...

A mineralocorticoid receptor antagonist (MRA or MCRA) [1] or aldosterone antagonist, is a diuretic drug which antagonizes the action of aldosterone at mineralocorticoid receptors. This group of drugs is often used as adjunctive therapy, in combination with other drugs, for the management of chronic heart failure .

2020年9月10日 · We aim to review the mechanism of action and safety profile of mineralocorticoid receptor antagonists (MRAs) and discuss the differences between selective and non-selective MRAs. More specifically, finerenone is a new medication that is currently under investigation for its promising cardiovascular and nephrological effects.

Steroidal MRA such as spironolactone and eplerenone have a proven renoprotective effect in CKD, indicating that binding to the MR is important for the inflammatory effect of aldosterone. But, there is a critical unmet need to slow progression of CKD to the end stage kidney disease, especially in patients with type 2 diabetes mellitus (T2D).

2022年2月22日 · Among several other pharmacological classes, mineralocorticoid receptor antagonists (MRAs) have received increasing interest, due to a growing body of high-quality evidence showing that spironolactone and eplerenone can significantly lower blood pressure and albuminuria in patients with CKD.

2021年10月21日 · Mineralocorticoid receptor antagonists (MRAs) are a promising therapeutic option in diabetic kidney disease (DKD) owing to the reported effects of...

2023年2月6日 · 在肾上皮细胞中，MR激活通过增加上皮钠通道（ENaC）活性以及K+排泄导致钠和液体滞留。 在中枢神经系统中，MR可能在血压调节中发挥作用；在脂肪组织中，MR过度激活可能与胰岛素抵抗和代谢综合征有关。 在心脏、肾脏和血管系统中，MR过度激活与组织重塑、功能障碍、炎症和纤维化有关。 心力衰竭和慢性肾脏病之间存在复杂的相互作用。 慢性容量和压力超负荷、贫血、神经激素失调（包括RAAS和交感神经系统激活）、氧化应激、炎症和纤维化以 …

2019年4月15日 · A new generation of nonsteroidal MRA has recently been developed to obtain a selective receptor block avoiding side-effects like hyperkalemia and thereby making the drugs suitable for administration to CKD patients.