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Diabetes (elevated blood sugar) is one of the most common causes of chronic kidney disease and is associated with heart disease. Optimal care requires several medications with different mechanisms of action to minimize the progression of kidney disease and reduce the risk of heart disease. Medications that block the effect of the hormone aldosterone belong to a group of drugs that help reduce the risks for heart disease and kidney failure. The side effects of this group of medications include a decrease in kidney function (which is typically transient and reversible), elevation in blood potassium concentration, breast pain, breast enlargement, and sexual dysfunction in men. These side effects are less common with the newer generation of medications such as finerenone. It is still recommended to monitor kidney function and serum potassium concentration prior to and 2-4 weeks after starting all medications that block the effect of aldosterone. Judicious use of an optimal medication regimen that includes drugs to block aldosterone is important to lower the risk for kidney failure and heart disease in patients with kidney disease from diabetes.

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This page is a summary of: Mineralocorticoid Receptor Antagonists in Diabetic Kidney Disease: Clinical Evidence and Potential Adverse Events, Clinical Diabetes, September 2024, American Diabetes Association,
DOI: 10.2337/cd24-0036.
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