Renoprotective Effects of Mineralocorticoid Receptor Antagonists Against Diabetic Kidney Disease.

Diabetic kidney disease (DKD) is a growing epidemic worldwide and a leading cause of end-stage kidney disease. Mineralocorticoid receptor (MR) blockade using Finerenone is a recently approved therapeutic approach to slow down the progression of DKD in patients with type 2 diabetes in addition to other therapies such as angiotensin-II converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), sodium-glucose co-transporter 2 (SGLT2) inhibitors, and glucagon-like peptide 1 (GLP-1) analogs. This review elaborates on the pathophysiologic pathways activated by aldosterone (the human mineralocorticoid) in DKD, the pharmacology of three different generations of mineralocorticoid receptor antagonists (MRAs), specifically, spironolactone, eplerenone, and finerenone, and the mechanisms by which these MRAs elicit their protective effects on the kidney under diabetic settings.

Impact of a Simulation Exercise on Student Perceptions of Poverty and Interprofessional Socialization.

OBJECTIVE: This study aimed to evaluate the impact of an interprofessional poverty simulation exercise by determining if participating students demonstrated changes in attitude toward poverty (ATP) and perceptions of interprofessional socialization. METHODS: The Community Action Poverty Simulation from the Missouri Community Action Network was provided to 512 interprofessional health care students during 9 simulation exercises over a 3-year period. Primary participating professions were pharmacy, occupational therapy, and nursing. Student simulation roles were assigned to ensure a mix of professions in simulated families and debriefing groups. Debriefing sessions included questions related to interprofessional interactions. Students completed surveys before and following participation in the simulation, which included the ATP Short Form scale and the Interprofessional Socialization and Valuing Scale-9A. RESULTS: Statistically significant improvements in ATP were demonstrated for the overall score and 15 items of the 21-item ATP Short Form scale. The domains of stigma and structural perspective showed statistically significant improvement, while the personal deficiency domain did not. Statistically significant improvements in student perceptions related to interprofessional socialization were demonstrated for the overall score and 7 items of the 9-item Interprofessional Socialization and Valuing Scale-9A scale. CONCLUSION: This interprofessional poverty simulation positively altered student ATP and enhanced interprofessional socialization. The Community Action Poverty Simulation augmented with debriefing questions related to interprofessional interactions served as an effective interprofessional education experience for pharmacy, occupational therapy, and nursing students.