Latest Real-world Study On Finerenone in The Treatment Of T2DM-related CKD Patients in China

Based on the large population base and population characteristics of the Chinese population, the proportion of patients with T2DM-related CKD combined with proteinuria is high in China, and the average proteinuria level and risk of progression to ESRD are both higher [2,3]. Faced with the "three highs" status quo, There is a clinical need to explore therapeutic drugs that are more in line with the characteristics of Chinese patients and have direct renal and heart target organ protection.

Click to Cistanche for kidney disease

This study is the first real-world investigation of the renal effects of fenelinone in patients with T2DM-related CKD. It is particularly noteworthy that compared with the previously published FIDELIO-DKD study [5], this study included patients with UACR>5000 mg/g for the first time, accounting for 14.3%. The study results show that even if the patient's baseline UACR level is >5000 mg/g, fenelidone treatment can still bring about significant improvement in proteinuria. In addition, 90.5% of the patients enrolled in this study received baseline SGLT2i treatment, which also provides reference for clinical combination therapy. Through in-depth research on specific populations, the efficacy and safety of fenelinone in people with massive proteinuria in T2DM-related CKD can be better understood.

Previous results from the FIDELITY Chinese subgroup [6] showed that the application of fenelidone in the Chinese population can significantly reduce the renal composite endpoint by 43%, and its effect is better than that of the overall population (23%). The results of this study also showed that more than half (68.43%) of the patients had a UACR decrease of ≥30% after treatment with fenelidone, and 47.37% of the patients had a UACR decrease of ≥50% after 6 months of treatment. It can be seen that the UACR of fenelidone It may have better proteinuria-lowering and renal-protective effects in the Chinese population.

Another highlight of this study is the treatment options for enrolled patients. The pathogenesis of T2DM-related CKD is complex and involves many aspects such as hemodynamics, metabolism, and inflammatory fibrosis. Therefore, comprehensive management of multiple mechanisms is crucial to improve patients' renal function and structural damage. Fennelidone exerts direct anti-inflammatory and anti-fibrotic properties by inhibiting the excessive activation of the mineralocorticoid receptor (MR) [7], more directly and comprehensively protecting the kidney and heart target organs, and promotes the upgrading of clinical treatment strategies.

Most of the patients enrolled this time have received RASi and SGLT2i treatment, and the study will further add fenelidone on this basis. The results showed that patients who received triple therapy with RASi, SGLT2i and fenelidone at the same time had a significant reduction in UACR, significant efficacy, good overall tolerance, and a low incidence of hyperkalemia. It can be seen that fenelinone can slow down the progression of kidney disease in patients, reduce proteinuria, and achieve long-term renal protection through its unique anti-inflammatory fibrosis mechanism. This also provides basis and confidence for the future clinical application of similar treatment options.

The study also has certain limitations. First, this is the first single-center retrospective study on the Chinese population, and extrapolation to other ethical groups should be done with caution. Secondly, the current study lacks larger sample size, long-term observation and randomization, therefore, randomized controlled trials with larger sample size and long follow-up time are needed to evaluate the combination of fenelidone and SGLT2i in patients with T2DM-related CKD Medication.

As the world's first nsMRA approved for the treatment of T2DM-related CKD, the renal and cardioprotective effects of fenelidone have been confirmed by multiple large-scale clinical studies. This real-world study conducted in China further supports the development of fenelidone in the treatment of T2DM. The application in patients with massive proteinuria in CKD provides new evidence. It is hoped that future clinical trials can further promote and explore the efficacy and safety of fenelinone in clinical T2DM-related CKD patients, and bring benefits to more patients.

How Does Cistanche Treat Kidney Disease?

Cistanche is a traditional Chinese herbal medicine used for centuries to treat various health conditions, including kidney disease. It is derived from the dried stems of Cistanche deserticola, a plant native to the deserts of China and Mongolia. The main active components of cistanche are phenylethanoid glycosides, echinacoside, and acteoside, which have been found to have beneficial effects on kidney health.

Kidney disease, also known as renal disease, refers to a condition in which the kidneys are not functioning properly. This can result in a buildup of waste products and toxins in the body, leading to various symptoms and complications. Cistanche may help treat kidney disease ase through several mechanisms.

Firstly, cistanche has been found to have diuretic properties, meaning it can increase urine production and help eliminate waste products from the body. This can help relieve the burden on the kidneys and prevent the buildup of toxins. By promoting diuresis, cistanche may also help Reduce high blood pressure, a common complication of kidney disease.

Moreover, cistanche has been shown to have antioxidant effects. Oxidative stress, caused by an imbalance between the production of free radicals and the body's antioxidant defenses, plays a key role in the progression of kidney disease. ies help neutralize free radicals and reduce Oxidative stress, thereby protecting the kidneys from damage. The phenylethanoid glycosides found in cistanche have been particularly effective in scavenging free radicals and inhibiting lipid peroxidation.

Additionally, cistanche has been found to have anti-inflammatory effects. Inflammation is another key factor in the development and progression of kidney disease. Cistanche's anti-inflammatory properties help reduce the production of pro-inflammatory cytokines and inhibit the activation of inflammation mandatory pathways, thus alleviating inflammation in the kidneys.

Furthermore, cistanche has been shown to have immunomodulatory effects. In kidney disease, the immune system can be dysregulated, leading to excessive inflammation and tissue damage. Cistanche helps regulate the immune response by modulating the production and activity of immune cells, such as T cells and macrophages. This immune regulation helps reduce inflammation and prevent further damage to the kidneys.

Moreover, cistanche has been found to improve renal function by promoting the regeneration of renal tubes with cells. Renal tubular epithelial cells play a crucial role in the filtration and reabsorption of waste products and electrolytes. In kidney disease, these cells can be damaged, leading to damaged renal function. Cistanche's ability to promote the regeneration of these cells helps restore proper renal function and improve overall kidney health.

In addition to these direct effects on the kidneys, cistanche has been found to have beneficial effects on other organs and systems in the body. This holistic approach to health is particularly important in kidney disease, as the condition often affects multiple organs and systems. che has been shown to have protective effects on the liver, heart, and blood vessels, which are commonly affected by kidney disease. By promoting the health of these organs, cistanche helps improve overall kidney function and prevent further complications.

In conclusion, cistanche is a traditional Chinese herbal medicine used for centuries to treat kidney disease. Its active components have diuretic, antioxidant, anti-inflammatory, immunomodulatory, and regenerative effects, which help improve renal function and protect the kidneys from further damage. , cistanche has beneficial effects on other organs and systems, making it a holistic approach to treating kidney disease.