Non-steroidal mineralocorticoid receptor antagonist (nsMRA)
Learn about a type of medicine called non-steroidal mineralocorticoid antagonist (nsMRA). It is a medicine that can slow the damage to the kidneys.
- Medically reviewed by
- AKF's Medical Advisory Committee
- Last updated
- September 19, 2024
What is a non-steroidal mineralocorticoid receptor antagonist (nsMRA)?
A non-steroidal mineralocorticoid receptor antagonist (nsMRA) is a type of prescription medicine that is taken by mouth used for people with kidney disease. Finerenone is the only medicine in this class of medicines that's currently FDA approved, but there are others that are in clinical trials
nsMRA is used for people with:
- Chronic kidney disease
- Type 2 diabetes
nsMRA can:
- Keep the filters (called glomeruli) in your kidneys healthy)
- Lower your urine albumin-creatinine ratio (UACR). A UACR can tell you how much protein is in your urine, which is a sign of kidney damage.
- Lower your chance of having kidney failure, heart failure, a heart attack, or stroke
How does nsMRA slow down the damage to my kidneys?
nsMRA slows down the damage to your kidneys by lowering the effect of aldosterone in your body. Aldosterone is a hormone (a chemical messenger) that helps balance your blood pressure by managing the amount of salt in your blood. In diseases like diabetes or chronic kidney disease, the body produces too much aldosterone. Too much aldosterone can cause your body to keep too much salt and water in your blood, which raises your blood pressure. Too much aldosterone can also cause scarring in the heart and kidneys. High blood pressure can damage the blood vessels in your kidneys, causing them to not work as well.
What are some common side effects of nsMRA?
Taking nsMRA may cause low blood pressure and a high amount of potassium in your blood (hyperkalemia).
Symptoms of low blood pressure may include:
- Feeling weak, dizzy, or lightheaded
- Feeling tired (fatigue)
You may have only a few, or no, symptoms of hyperkalemia. Your doctor will likely do blood tests to check the amount of potassium in your blood after you start taking nsMRA.
Signs of severe hyperkalemia may include:
- Muscle weakness or numbness
- Feeling sick to your stomach (nausea)
- A fast-beating heart (heart palpitations)
- Chest pain
It is important to talk to your healthcare provider about medication and medication management questions you have.
