Multicriteria neutrosophic method for the evaluation of finerenone in diabetic kidney disease

Abstract

Diabetic Kidney Disease (DKD) is one of the most serious complications of Diabetes Mellitus (DM) and is the main cause of end-stage renal disease. Chronic hyperglycemia triggers a series of alterations in renal cells, generating progressive damage at both the glomerular and tubular levels. In addition, factors such as metabolic alterations, arterial hypertension and activation of the Renin-Angiotensin-Aldosterone System (RAAS) play a crucial role in the development of microvascular lesions. The treatment of this condition includes therapy with antidiabetics, as well as blockade of the RAAS. In this regard, finerenone, a new antagonist of mineralocorticoid receptors, has shown promising results by reducing proteinuria and slowing the progression of DKD. In addition, the combination of finerenone with SGLT-2 inhibitors has demonstrated therapeutic synergism, resulting in a decrease in albuminuria and a lower cardio-renal risk. Although specific studies on the co-administration of finerenone and GLP-1 receptor antagonists (GLP-1RAs) have not yet been carried out, it is suggested that this combination could have beneficial effects on the progression of CKD. The aim of this research is to develop a multicriteria neutrosophic method that allows a comprehensive evaluation of the efficacy of finerenone in diabetic kidney disease, thus contributing to the advancement of therapeutic strategies for this condition.