Dr. Mario Funes Hernandez is a clinical research nephrology fellow at Stanford University. He obtained his medical degree at the National Autonomous University of Honduras. His Internal Medicine residency was at Saint Peter’s University Hospital/Rutgers Robert Wood Johnson Medical School, serving as assistant chief resident and was a recipient of the Sister Marie de Pazzi award as best resident of the Internal Medicine Class of 2020. He’s the current Nephrology Chief Fellow, a Heart Health Tech Fellow at the Stanford Center of Digital Health and a student in the Master of Science of Epidemiology and Clinical Research. Dr. Funes Hernandez has an American Heart Association Research Supplement to Promote Diversity in Science award to assist in the development of digital health technology tools in the management of hypertension in patients with chronic kidney disease and resistant hypertension.
Member (Postdoc), Cardiovascular Institute
Honors & Awards
UCSF-Stanford CERSI Diversity Scholars Program, UCSF-Stanford Center of Excellence in Regulatory Science and Innovation (CERSI) (2021-2022)
Sister Marie de Pazzi Award (best resident award of the Internal Medicine Class of 2020), Saint Peter’s University Hospital/Rutgers Robert Wood Johnson Medical School (2020)
Outstanding PGY2 Resident Award, Saint Peter’s University Hospital/Rutgers Robert Wood Johnson Medical School (2019)
Outstanding PGY1 Resident Award, Saint Peter’s University Hospital/Rutgers Robert Wood Johnson Medical School (2018)
Chief Fellow, Stanford University Nephrology Fellowship (2021)
Assistant Chief Resident, Saint Peter’s University Hospital/Rutgers Robert Wood Johnson Medical School, Internal Medicine (2020)
Board Certification, American Board of Internal Medicine, Internal Medicine (2020)
Residency, Saint Peter’s University Hospital/Rutgers Robert Wood Johnson Medical School, Internal Medicine Residency (2020)
M.D., National Autonomous University of Honduras (2015)
Current Clinical Interests
- Hypertension, Renovascular
- Resistant Hypertension
Technology-Enabled Management of Hypertension in Patients with Resistant Hypertension and Chronic Kidney Disease
Cardiovascular and Renal Outcomes with Finerenone, a Selective Mineralocorticoid Receptor Antagonist.
Cardiology and therapy
Overactivation of the renin-angiotensin-aldosterone system (RAAS) has been shown to be pathologic in heart failure and albuminuric chronic kidney disease (CKD), triggering pro-inflammatory and pro-fibrotic cellular pathways. The standard of care in these disease states includes treatment with angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers. Mineralocorticoid receptor antagonists (MRAs) are also a mainstay in the treatment of heart failure with reduced ejection fraction; however, therapy is often limited by treatment-related hyperkalemia. In albuminuric CKD, the risk of hyperkalemia, acute kidney injury (AKI), and hypotension also remains significant. Finerenone is a novel non-steroidal MRA that may obviate some of these concerns and have therapeutic potential in additional patient populations. Finerenone was developed using the chemical structure of a dihydropyridine channel blocker but optimized to create a bulky MRA without any activity at the L-type calcium channel. It has several novel cellular mechanisms that may account for its ability to reduce cardiac hypertrophy and proteinuria more efficiently than an equinatriuretic dose of a steroidal MRA, while retaining anti-inflammatory and anti-fibrotic properties. Finerenone also has a lower rate of treatment-related hyperkalemia and AKI than steroidal MRAs with a smaller effect on systolic blood pressure, greatly expanding its therapeutic utility. The recently published FIGARO-DKD and FIDELIO-DKD trials demonstrate that treatment with finerenone in patients with typeII diabetes and albuminuric CKD results in improved cardiovascular outcomes and a lower risk of CKD progression. Patients enrolled in these studies were already on maximally tolerated ACE inhibitor or angiotensin receptor blocker therapy. Trials investigating finerenone's therapeutic effect in patients with heart failure with preserved ejection fraction (HFpEF) and non-diabetic CKD, as well sodium-glucose cotransporter2 (SGLT2) and finerenone combination therapy in patients with diabetic nephropathy, are ongoing.
View details for DOI 10.1007/s40119-022-00269-3
View details for PubMedID 35737275
- Self-limited Hypertension Due to Kidney Infarction. Kidney medicine 2022; 4 (5): 100454
- Hypothesis: Accessory renal arteries may be an overlooked cause of renin-dependent hypertension. Journal of human hypertension 2021