Meta-Analysis of the Efficacy and Safety of Finerenone in Diabetic Kidney Disease.

BACKGROUND: The phase III clinical trial of the nonsteroidal mineralocorticoid receptor antagonist finerenone (BAY 94-8862) has been completed, aiming to investigate renal and cardiovascular outcomes in type 2 diabetes (T2D) with chronic kidney disease (CKD). However, the efficacy and safety of finerenone in renal function remain controversial. The purpose of this study was to explore the efficacy and safety of finerenone in treating the patients with diabetic kidney disease (DKD). METHODS: Databases of PubMed, Cochrane Library, Embase, and Web of Science were searched for randomized controlled trials (RCTs) on patients with DKD receiving finerenone treatment from inception to September 2021. Data including patient characteristics and interested outcomes were extracted, and the dichotomous data and continuous variables were evaluated using risk ratio (RR) with 95% confidence intervals (CIs) and mean differences (MD) with 95% CIs, respectively. RESULTS: A total of 4 RCTs involving 13,945 patients were included in this meta-analysis. Analysis results demonstrated that patients receiving finerenone showed a significant decrease in changing urinary albumin-to-creatinine ratio (UACR) from baseline (MD: -0.30; 95% CI [-0.33, -0.27], p = 0.46, I2 = 0%) (p < 0.05). The number of patients with ≥40% reduction in estimated glomerular filtration rate (eGFR) from baseline in the finerenone group was significantly smaller than that in the placebo group (RR: 0.85; 95% CI [0.78, 0.93], p = 0.60, I2 = 0%) (p < 0.05). No difference was found in adverse events between the finerenone and placebo groups (RR: 1.00; 95% CI [0.98, 1.01], p = 0.94, I2 = 0%) (p = 0.65). The incidence of hyperkalemia was higher in the finerenone group than that in the placebo group (RR: 2.03; 95% CI [1.83, 2.26], p = 0.95, I2 = 0%) (p < 0.05). CONCLUSION: Finerenone contributes to the reduction of UACR and can ameliorate the deterioration of renal function in patients with T2D and CKD. The higher risk of hyperkalemia was found in the finerenone group compared with placebo; however, there was no difference in the risk of overall adverse events.

Rechargeable-battery chemistry based on lithium oxide growth through nitrate anion redox.

Next-generation lithium-battery cathodes often involve the growth of lithium-rich phases, which enable specific capacities that are 2-3 times higher than insertion cathode materials, such as lithium cobalt oxide. Here, we investigated battery chemistry previously deemed irreversible in which lithium oxide, a lithium-rich phase, grows through the reduction of the nitrate anion in a lithium nitrate-based molten salt at 150 °C. Using a suite of independent characterization techniques, we demonstrated that a Ni nanoparticle catalyst enables the reversible growth and dissolution of micrometre-sized lithium oxide crystals through the effective catalysis of nitrate reduction and nitrite oxidation, which results in high cathode areal capacities (~12 mAh cm-2). These results enable a rechargeable battery system that has a full-cell theoretical specific energy of 1,579 Wh kg-1, in which a molten nitrate salt serves as both an active material and the electrolyte.

A Molten Salt Lithium-Oxygen Battery.

Despite the promise of extremely high theoretical capacity (2Li + O2 ↔ Li2O2, 1675 mAh per gram of oxygen), many challenges currently impede development of Li/O2 battery technology. Finding suitable electrode and electrolyte materials remains the most elusive challenge to date. A radical new approach is to replace volatile, unstable and air-intolerant organic electrolytes common to prior research in the field with alkali metal nitrate molten salt electrolytes and operate the battery above the liquidus temperature (>80 °C). Here we demonstrate an intermediate temperature Li/O2 battery using a lithium anode, a molten nitrate-based electrolyte (e.g., LiNO3-KNO3 eutectic) and a porous carbon O2 cathode with high energy efficiency (∼95%) and improved rate capability because the discharge product, lithium peroxide, is stable and moderately soluble in the molten salt electrolyte. The results, supported by essential state-of-the-art electrochemical and analytical techniques such as in situ pressure and gas analyses, scanning electron microscopy, rotating disk electrode voltammetry, demonstrate that Li2O2 electrochemically forms and decomposes upon cycling with discharge/charge overpotentials as low as 50 mV. We show that the cycle life of such batteries is limited only by carbon reactivity and by the uncontrolled precipitation of Li2O2, which eventually becomes electrically disconnected from the O2 electrode.