Mineralocorticoid receptor antagonists in the clinical practice of internal medicine

Mineralocorticoid receptors play a crucial role in the pathogenesis of various internal organ diseases, including heart failure, arterial hypertension and chronic kidney disease. Their excessive activation promotes inflammation, fibrosis, tissue remodeling, and contributes to the development of the cardiorenal-metabolic syndrome. The efficacy of mineralocorticoid receptor blockade in achieving cardioprotective and renoprotective effects has been confirmed by large experimental and clinical studies. At the same time, there are significant differences in the pharmacological properties of steroidal and non-steroidal mineralocorticoid receptor antagonists.

This article presents the characteristics of mineralocorticoid receptor antagonists registered in the Russian Federation, including their clinical effects, safety profiles, and indications for use. Special attention is given to the algorithm of drug selection, taking into account individual patient characteristics and the balance of potential benefits and risks. The material is based on up-to-date European and national clinical guidelines and is intended for practical use by internists in the management of patients with cardiovascular and renal diseases.

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