th a paucity of high-quality clinical trials in this area. Furthermore, late referral can result in poor patient outcomes. This article reviews the current management of nondiabetic glomerular disease and explores the latest developments in drug treatment in this area. Current treatment of nondiabetic glomerular disease aims to manage complications (edema, hypertension, proteinuria, hyperlipidemia, hypercoagulability, and thrombosis) as well as target the underlying cause of glomerular disease. Treatment options include renin-angiotensin-aldosterone system inhibitors, statins/nonstatin alternatives, loop diuretics, anticoagulation agents, immunosuppressives, and lifestyle and dietary modifications. Effective treatment of nondiabetic glomerular disease is limited by heterogeneity and a lack of understanding of the disease pathogenesis. Sodium-glucose cotransporter-2 inhibitors and nonsteroidal mineralocorticoid receptor antagonists (ns-MRAs, such as finerenone), with their broad anti-inflammatory and antifibrotic effects, have emerged as valuable therapeutic options for a range of cardiorenal conditions, including CKD. ns-MRAs are an evolving drug class of particular interest for the future treatment of nondiabetic glomerular disease, and there is evidence that these agents may improve kidney prognosis in various subgroups of patients with CKD. The benefits offered by ns-MRAs may present an opportunity to reduce the progression of CKD from a spectrum of glomerular disease. Several novel ns-MRA are in clinical development for both diabetic and nondiabetic CKD....

中文翻译：

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盐皮质激素受体拮抗剂在非糖尿病慢性肾脏病和肾小球疾病中的潜在作用


该领域缺乏高质量的临床试验。此外，延迟转诊会导致患者预后不佳。本文回顾了当前非糖尿病性肾小球疾病的管理，并探讨了该领域药物治疗的最新进展。目前对非糖尿病性肾小球疾病的治疗旨在管理并发症（水肿、高血压、蛋白尿、高脂血症、高凝状态和血栓形成）以及针对肾小球疾病的根本原因。治疗选择包括肾素-血管紧张素-醛固酮系统抑制剂、他汀类/非他汀类药物替代品、袢利尿剂、抗凝药、免疫抑制剂以及生活方式和饮食调整。非糖尿病性肾小球疾病的有效治疗受到异质性和缺乏对疾病发病机制的理解的限制。钠-葡萄糖协同转运蛋白-2 抑制剂和非甾体盐皮质激素受体拮抗剂 （ns-MRA，如 finerenone） 具有广泛的抗炎和抗纤维化作用，已成为包括 CKD 在内的一系列心肾疾病的有价值的治疗选择。ns-MRA 是一类不断发展的药物，对未来非糖尿病肾小球疾病的治疗特别感兴趣，有证据表明这些药物可以改善 CKD 患者各个亚组的肾脏预后。ns-MRA 提供的益处可能为减少 CKD 从一系列肾小球疾病的进展提供机会。几种新型 ns-MRA 正在临床开发中，用于治疗糖尿病和非糖尿病 CKD。