577
PŘEHLEDOVÉ479422001004388130181216258306358404446
ČLÁNKY525622001003973122176223272
Finerenon43453300100375290126150185222261299
v4661330010035
interní47123300100145278113138176191
a4920330010033
kardiologické49703300100336993130146184200239278293323357392
praxi53783300100376197134150
|5584220010018
241564222001003676101
/36088040010732
Vnitř3685804001074592111139166
Lék.3870804001074184122140
2025;71(4):241-2484030804001074487128172185226267286327349363407447485509547587633
/47088040010732
VNITŘNÍ48058040010746106127172221280301
LÉKAŘSTVÍ5128804001074084130188235279325377399
www.casopisvnitrnilekarstvi.cz42580400107651332012142542953293774274464795215705896176436927117307748128548809159449871007102310631101
https://doi.org/10.36290/vnl.2025.044432844001003865941331631802022234550440010041831024652440010015547911713947934400100287389124167204247293316355396414432470516552587605649691734
Finerenon42598002751171813094285216407688941022
v15249800275120
interní1691980027561188278395488615681
a24499800275116
kardiologické261398002751212423354635296547208469741040114112681383
praxi40739800275124216335460525
Markéta4251370013793152194253310351410
Ječmenová8571370013745103154249307373436493551
InterMedCare,425152001332687122176211299354417481534569623645
s.1093152001334467
r.1183152001333653
o.,1260152001336081104
Interní1388152001332686121175211272297
a17081520013353
kardiologická17841520013352106141202227288313374436461509560614
ambulance24211520013353144206267292344405454507
Brno2951152001336096157217
Finerenon425203001214972128180214265321377434
je886203001212475
vysoce9882030012148100140196243293
selektivní,1308203001213991116167215252276325383407428
nesteroidní17632030012155107147182233266322346404460484
antagonista22742030012148105138188245301357382422457506
mineralokortikoidního28072030012183108164215249299323379427482516553577625679704761818842900956
receptoru3790203001213283130180238272327361418
(MR)42342030012129108163192
s44522030012140
vyšší45182030012148100141180205
vazebnou4749203001214898142193251308364420
afinitou5196203001214878106162186220275331
než4252170012155107151
spironolakton596217001214097122155210267323348397445482537593
nebo12092170012156107165222
eplerenon.14512170012150108133184218269325381438460
Na19312170012166115
rozdíl2066217001213388131189213239
od23252170012155113
těchto2458217001213383130186219274
steroidních2752217001214074125159214238296352376422478
inhibitorů3250217001212379136160217242276331365421
MR36912170012180135
prokázal3846217001215791147195245289340365
finerenon4231217001212956112163197248305361417
jak4668217001212574121
kardiovaskulární,4809217001214797131188212268316365405453509534583616673697719
tak425231001213383131
i5812310012124
renální630231001213384141190214270294
benefit.9502310012157109165217247275309331
Finerenon1307231001214872128179213264321377434
redukuje1766231001213384142198245302327378
albuminurii,2169231001214973131187271295352407441465489511
která2706231001214683134168217
představuje2949231001215790141199240275324372429453505
časnější3479231001214595135191242267307331
a38362310012148
citlivější3909231001214569103128151201251276316340
marker42742310012184133166214264298
chronického45982310012145101134190246270316364414470526
onemocnění515023100121551121632483043514252450012155107163187
ledvin640245001212475134183208264
a9322450012148
zvýšeného1008245001214395146187238295346403459
KV14952450012154115
rizika1638245001213257101125173223
než18892450012155107151
samotný2068245001213989174230264320366
pokles24622450012157114162188240280
eGFR27702450012150117167220
(estimated3018245001212876117152176260309342393451
glomerular3497245001215680136221272306363387436469
filtration399424500121305781115148198231255312368
rate4390245001213382116166
–45842450012150
odhadnutá46622450012155113169218276332388422472
hodnota51622450012155112170226282316366
glomerulární425259001215680136221273306363387436470527551
filtrace).100025900121295680114148197243293320339
Také1363259001215092140190
u15772590012155
pacientů16562590012157107153177228285318374
se2054259001213991
srdečním2169259001213973130181228284308392
selháním2585259001214091116172221278302386
zvyšuje2995259001214395146187242267318
albuminurie3337259001214873130187271295351407440465516
riziko3877259001213358101126173228
progrese4129259001215791147204238289329380
srdečního4533259001214073131182228285309367423
selhání4980259001214091116172221277301
nebo53052590012156107165222
kardiovaskulárního425273001214797131188212268316366406453510534583617673698756812
úmrtí.12642730012155139173210234255
Finerenon1547273001214872128179213264321377433
je2008273001212475
v21102730012148
současnosti2186273001213995152198247287343399440475499
indikován2712273001212379137161209263312361417
u31562730012155
dospělých32392730012156112152210262287335380436
pacientů37022730012157107153177228284318374
k41032730012147
léčbě4177273001212375121179230
chronického44352730012144100134189246270316363413470526
onemocnění49882730012155112163248304351407458515539
ledvin425287001212475133183208264
s7112870012140
albuminurií,773287001214873130187271295351407440465489511
spojeného1306287001214097154179230287338395451
s17802870012139
diabetem1842287001215680129187239273323408
mellitem22722870012184135160184208243293377
2.2672287001215173
typu.2768287001213384142199221
Tito3011287001215076110165
pacienti31982870012157107153177228284318342
by35622870012157104
měli36892870012183135160184
být38952870012157104142
léčeni4059287001212475122171228252
maximální43342870012183132181205289338363419443
tolerovanou4799287001213489114165199254303352408464521
dávkou534228700121561061534253010012147102158
inhibitorů606301001212379136160217242276331365421
systému1050301001214089129164214299355
renin-aniotenzin-aldosteronového14273010012133841411652212543033603844404745245816256497057387888128709269661001105110851141119712531301135214081464
systému2914301001214089130164215299355
a32923010012148
gliflozinem.3363301001215680104134162218261285341393477500
Pokud38853010012153108156212270
se4178301001213991
jedná4291301001212576134191240
o45533010012155
pacienta46313010012157107152176228284318368
se5021301001214091
srdečním5135301001214073130181228284308392
selháním,425315001213991116171220276300384406
musí8503150012184139179203
mít10733150012183107141
ejekční1233315001215075126174218274298
frakci1551315001212963112160204228
levé1799315001212374123173
komory19913150012147102186242275327
≥23373150012160
4024163150012152105
%.25413150012179102
Před2662315001215386136194
zahájením2876315001214393149198223274330354438
léčby3334315001212374121178225
finerenonem3579315001212956112163197247304359416467551
je4150315001212475
nutné42453150012155111145201252
znát4517315001214299147181
eGFR,47173150012150117166219243
kalemii4980315001214797121172256280304
a53043150012148
UACR537231500121641234253290012158112
(urine559329001212981115139196247
albumin-creatinine829329001214872130186270294351384432466516566599623679703760811
ratio1662329001213383116140196
–18813290012150
poměr19533290012157114198250284
albuminu2259329001214873130186271295351407
a26883290012148
kreatininu2759329001214782133182215239295319376431
v32133290012148
moči);32833290012184140186210238258
léčbu3563329001212475122179236
je3821329001212476
možno39193290012184140183239295
zahájit4237329001214394150199224248282
při4541329001215791115
eGFR46793290012150116167220
25–5949213290012151103156207256
ml/min,52003290012183108143225249306327
kalemii425343001214797121172256280304
pod7493430012157114171
5,0940343001215171124
mmol/l10863430012183167223248283309
a14143430012148
UACR14823430012165124180234
≥17353430012160
318143430012152
mg/mmol18883430012183140176258341397422
(≥2330343001212886
3024353430012152103
mg/g).25603430012184141176229256276
Po28553430012153107
zahájení2982343001214393149198223274330354
léčby3356343001212374121178225
je3601343001212475
nutno36963430012155111145201256
v39723430012148
čtyřtýdenním4040343001214581131165202252309360416472496580
intervalu4640343001212379112162196248297321377
kontrolovat50373430012146101157190224279304360408457490
hladinu425357001215580129187211267323
kalemie770357001214797122173258282333
a11263570012148
eGFR.11973570012150116167220244
Pokles14633570012154108156182233274
UACR17603570012164124180234
je2017357001212475
možno21153570012183140183239295
pozorovat24333570012157114157212246302350399433
již288935700121244892
po30043570012156113
431403570012151
měsících32143570012183135175199245269314370
léčby3607357001212475122179226
a38563570012148
je3927357001212476
dobrým40253570012157113171205256341
markerem43893570012184133166214264298349433
adherence48453570012148106162214248298355401451
pacientů531935700121571061521764253710012150107140196
k6463710012147
léčbě.718371001212375121179231251
V9943710012156
článku1075371001214468117174221278
je1378371001212475
dále14783710012157106130182
diskutován1685371001215680120168224259314362411467
dopad21773710012157113171221279
na24813710012155104
hodnoty26103710012156112170226282316367
krevního3002371001214782133181239263321377
tlaku,3404371001213357106154210232
albuminurii3661371001214873130187271295351407440465489
a41753710012148
renální4248371001213384141190214270294
funkce.4567371001212986143190235285306
Jsou4898371001213777133189
probírány5112371001215791147205230263313369415
i4253850012123
možné4723850012183139182239290
nežádoucí7853850012156107152202260316372418442
účinky.12513850012155101124181228280297
Celý15713850012158108133182
článek1776385001214569118174225274
ilustrativně2073385001212347103143178212261295319368425477
doplňují25733850012156112170196252307332356
dvě29523850012157106156
kazuistiky3131385001214797142198222262297321369420
pacientů35743850012157107153176228284318373
léčených3971385001212375121171228274319375
finerenonem.4369385001213057113164198249306362419470555577
Klíčová425402001235885111155211261312
slova:764402001234167124174225248
albuminurie,1039402001214872128183267290345400432456506526
diabetes1592402001215780128184235269318358
mellitus19774020012183134158181204237292331
2.2335402001215273
typu,2435402001213383141196217
finerenon,2679402001213056111161194244300355411432
glifloziny,3138402001215679102131158213255278333379395
chronické35604020012145100132187243266311357406
onemocnění39934020012155111161245300346401451507530
ledvin,4550402001212474131180204259280
kalemie,4857402001214796120170253277327347
kardiovaskulární5231402001214796129185208263425416001214897136182238261309342397421
marker.8674160012183131164211260293309
Finerenone425441001506497166229278342410477545609
in10724410015033101
internal12124410015033101148211260328393427
medicine16774410015099163232266319354422485
and22014410015063131200
cardiology24404410015052117166234269336370438506575
practice30534410015067116180233281316369432
Finerenone425461001214971126177210259315370426476
is921461001212362
a10034610012148
highly1071461001215578134189213260
selective,1351461001213990114164210245268316365385
non-steroidal17564610012155110166198238272321354409432489537560
mineralocorticoid23364610012183106162212245293317372418471504540563608662685742
receptor3097461001213383128177234267321354
antagonist34714610012148103136185240296351374414447
with3938461001217497130185
high4143461001215579134190
binding4352461001215781136193216271327
affinity4699461001214877109136191214247297
(higher5015461001212984107163218269302
than5336461001213388136192
spironolactone425475001214097121154210266322347395441477532588639
and10934750012149105162
eplerenone).12844750012151109133184218268325381437488514533
In1846475001212480
contrast19554750012145100156189222272311346
to2330475001213388
the2447475001213389140
steroidal2616475001214075125158213237295343367
mineralocorticoid30124750012184108164215249298322378424479512549572618672696753
receptor3794475001213384130180238271326360
antagonists,41834750012148104137187244300356380419454495517
finerenone4728475001213057113164197248304360417468
proved5225475001215791146194244302
cardiovascular425489001214594126182205260308356395440495518566599
and10454890012148104160
renal1226489001213383139187210
benefit.14574890012157108164214244270303324
Finerenone444503001214971126177210259315370426476
reduces940503001213282140194239288328
albuminuria,1287503001214872128184267290345400432456504525
which18315030012174130153197252
is2103503001212362
a21855030012148
sensitive2252503001214090146185208241264312361
marker26325030012184132164212260293
of2945503001215584
chronic30485030012145100132187242266310
kidney3378503001214771128183234280
disease3678503001215679118169217256306
and40045030012148103160
cardiovascular4183503001214594126182205260308356395440495518566599
risk.480150300121335796142165
It4985503001212457
is5062503001212362
an51435030012149104
earlier5266503001215098131154177228261
marker4255170012183131163209258290
than733517001213387135190
decreased9405170012156106151184233281319369426
glomerular1384517001215578133216266299353377424456
filtration185851700121295578110142190223245300355
rate2231517001213280112161
(GFR).2410517001212890138190217235
Albuminuria2663517001216184140195277300355409441464512
is3192517001212462
a32725170012148
marker33375170012183131163210258291
of3645517001215584
increased3746517001212378123155204252290340397
risk416151700121325594140
of4319517001215483
progression4420517001215689143199231281320359381436491
of4928517001215584
heart50295170012156106153185221
failure5267517001212978101124178210259
and4255310012148102158
cardiovascular600531001214593125180203257304352390435489512559591
death.12085310012156106153185239260
Currently,14855310012158110142175224279310333380396
finerenone1898531001212954109159191240295349404454
is2369531001212462
indicated2448531001212478134157201249281329386
to2851531001213386
adult29545310012148104158181214
patients31855310012156104136159208263295335
with3537531001217396129183
type3738531001213282139189
239445310012151
diabetes4012531001215679126182232265314353
mellitus43825310012183133156179201234288327
with4726531001217396129183
chronic4926531001214599131185240262306
kidney5250531001214670126181231277
disease425545001215680119169217256307
with755545001217397130185
albuminuria.963545001214972128184267290345400433456504525
These15115450012150106157196247
patients17815450012157105138161211267299340
should2144545001213995150205228285
be24525450012157108
treated2583545001213365115163196245302
with2908545001217498131186
maximal31175450012183131179202286334357
tolerated3497545001213387111162194243275325382
doses39025450012156112151201241
of4166545001215584
renin4273545001213282138161216
angiotensin45125450012148104160183238271320376415438493
aldosterone5028545001214872128183222256306338393449499
system425559001214088127161211294
inhibitors742559001212479134157214238271325358398
and11635590012148104160
gliflozins.1347559001215579102131158213255278333372394
If1764559001212453
a18415590012148
patient19125590012157106138161211267299
had22355590012155103160
a24185590012148
heart24895590012156106154187223
failure,2735559001212978101124179212261281
the3040559001213388138
ejection3201559001215174125170206229284339
fraction3564559001212962111156191214269325
should3912559001214095150205229285
be42205590012157108
above43515590012149105161208257
4046315590012152104
%.47595590012179101
Before49065590012155105135190223273
starting5202559001214073122155191214269325
the425573001213388139
therapy590573001213388138171220276323
with939573001217397130185
finerenone,1150573001212955111161194244299354410461480
it1656573001212457
is1739573001212362
necessary18275730012156106152201240279328361411
to2264573001213387
know23775730012147104159232
the2635573001213388139
GFR,27995730012165114166189
potassium30145730012157113146195234273296350434
level3473573001212474122171195
in3694573001212379
serum3799573001213990122178261
and40865730012148103160
urine4272573001215588111166217
albumin-creatinine4515573001214871128183266290345377424457507555587610665689744794
ratio5335573001213381114137192
(UACR).425587001212892150206259286305
The7525870012150106157
therapy931587001213389139172220277323
can1277587001214594149
be14485870012157108
initiated1579587001212378102135158206238287345
if1946587001212453
GFR20225870012164113165
is2210587001212362
25–59ml/min,22955870012151102154204252336359394475498553574
potassium28925870012156112145194233272295350433
level3348587001212374121170194
below35655870012157108132187260
5,03847587001215271122
mmol/L39925870012183167222246280328
and43435870012148103160
UACR45255870012165123179232
above47795870012148105161208257
3mg/mmol50595870012151134190225306389444468
(≥425601001212885
305386010012151102
mg/g).6676010012183140175226253271
The9666010012150106156
potassium11506010012157113146194234273296350433
serum1611601001214090123178262
level1900601001212474122171195
and21226010012148104160
GFR23106010012164113166
should2503601001214095150205229285
be28166010012157108
controlled2951601001214599154187219274298321371429
within3407601001217497130186209264
a36986010012149
437746010012151
weeks38536010012174123174221264
interval4144601001212479111160193244293316
after4488601001214877113163195
the4711601001213388139
initiation4877601001212479102135158206238261316372
of5277601001215584
the5388601001213388139
therapy.425615001213388139172220277323339
Decreased7846150012167118164196246294333383441
UACR12456150012164123178231
can1496615001214593149
be16656150012156107
observed17926150012155112152202235286335393
after2204615001214978114163196
424206150012151
months24916150012184139195227282321
of2832615001215584
therapy2936615001213388139171220277323
and32796150012148103160
it3459615001212356
is3535615001212463
a36186150012148
very3686615001214897130180
good38866150012156111167224
marker41306150012183131164211260293
of4443615001215584
the4547615001213388138
patient’s47056150012157106138161212267300324360
adherence50856150012148105160210243293349394443
to425629001213386
the529629001213387137
therapy.684629001213387137170218274320336
The10376290012150105155
article,1210629001214880115138182205255274
beside15026290012157107146169225274
the1794629001213387137
possible19496290012156112150189212268291341
side2308629001213962118168
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