Ps-r05-2: esaxerenone ameliorates egfr deterioration and urine protein secretion in diabetes mellitus (dm) nephropathy: long time follow-up

Introduction: Mineralocorticoid antagonist (MRA) not only reduce cardiovascular event, but also may have the probable renoprotective events, likewise other RAAS inhibitors. Here we experienced that esaxerenone ameliorates eGFR deterioration and urine protein secretion in severe DM nephropathy. Patient Presentation: 72-years-old, Female. She referred to our hospital in order to investigate DM retinopathy. She already had DM nephropathy (Cr 0.95 mg/dL, eGFR 44.4 mL/min/1.73m2) with severe urine protein (11.2 g/gCre), and eGFR was decreased -10 mL/min/1.73m2 per year. We started esaxerenone with conventional therapy using ARB. After initiation of esaxerenone, eGFR decreasing rate was significantly ameliorated (eGFR: -4 mL/min/1.73m2 per year). In addition, urinary protein levels were decreased by as much as 98% (urinary protein levels after the initiation were 0.25 g/gCre). Discussion: Esaxerenone may have the additional renoprotective effect with conventional RAAS therapy. The evidence on renoprotective effects of MRA will be reviewed along with the case presentation.