What kind of drugs does Fenelidone (Keshenda) belong to and its mechanism of action is comprehensively analyzed

Finerenone is a selective non-steroidal mineralocorticoid receptor antagonist (MRA). Compared with traditional steroids MRA (such as spironolactone, eplerenone), it has higher receptor selectivity and tissue specificity, and shows advantages in cardiorenal protection. It is mainly used for the treatment of patients with chronic kidney disease (CKD) and type 2 diabetes. It also has potential application value in the management of heart failure, proteinuria and hypertension.

Fenelinone blocks the pathological effects of aldosterone and other mineralocorticoids on the heart, kidneys and blood vessels by selectively binding to the mineralocorticoid receptor (MR). MRActivation can lead to inflammatory responses, fibrosis and oxidative stress, thereby accelerating renal function decline and cardiovascular damage. The antagonism of fenelinone can inhibit these pathological signals, reduce structural damage to cardiac and renal organs, and improve tissue function.

Clinical and basic research shows that fenelidone can effectively inhibit the expression of fibrosis markers (such as TGF-β, collagen) in kidney and heart tissue, reduce tissue sclerosis, and inhibit the release of inflammatory mediators (such as TNF-α, IL-6). These effects not only delay the progression of chronic kidney disease but also reduce the risk of cardiovascular events. Compared with traditional steroid MRAs, fenelidone shows higher targeting and safety in controlling inflammation and fibrosis.

By inhibiting MR activation and downstream inflammatory fibrosis pathways, fenelidone can significantly reduce proteinuria, slow down the decline of renal function, and reduce the risk of heart failure and cardiovascular events in patients with chronic kidney disease. At the same time, due to its non-steroidal structure, its high selectivity reduces the risk of hyperkalemia and hormone-related side effects, making long-term use safer and tolerable. In the future, fenelidone may become one of the core drugs in the management of chronic kidney disease and cardiovascular disease.

Reference materials:https://www.drugs.com/