The excessive activation of the mineralocorticoid receptor(MR)is closely linked to the development and progression of diabetic kidney disease(DKD).Mineralocorticoid receptor antagonists(MRAs)play a protective role in DKD by inhibiting MR,which lead to anti-inflammatory and anti-fibrotic effects,ultimately improving organ damage.Steroidal MRAs have a well-established mode of action,but their use is limited due to adverse effects such as hyperkalemia and hormonal disturbances.In recent years,non-steroidal MRAs have emerged as a promising option for DKD treatment,demonstrating significant efficacy along with greater selectivity and improved safety profiles.They are considered a novel therapeutic approach to slow down the progression of DKD.This paper offers a comprehensive review of the mechanisms and clinical research advancements related to MRAs in the treatment of DKD,aiming to provide valuable insights for clinical practice.
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