Introduction:
Finrenone is a novel non-steroidal mineralocorticoid receptor (MR) antagonist. Expression of MR on distal nephron, podocytes, fibroblasts, vascular cells, and macrophages is important contributor to inflammation, tubular damage and progression of fibrosis in kidneys of patients with diabetic nephropathy (DN). Finrenone has shown potential to lower the rates of decline in kidney function, kidney failure or death associated with kidney disease. It also shown to reduce the risk of cardiovascular outcomes. However, there is lack of data with finrenone in Indian setting. Thus, we conducted this retrospective study with the objective to assess the impact of finrenone on kidney function in DN.
Methods:
We retrospectively analyzed the data of DN due to type 2 diabetes, who had received finrenone, had serum potassium < 4.8 mEq/L and eGFR >25 ml/min/1.73 m2. Data on patient demographics, urine albumin creatinine ratio (UACR), serum creatinine (SCr) and serum potassium levels were assessed at baseline and at latest follow-up. Data was analyzed with descriptive statistics with appropriate statistical measures and tests. The study was approved from institutional ethics committee.
Results:
Between August 2022 and May 2024, a total of 31 DN patients had received finrenone. The median age was 67 years (range: 38 to 82 years) and 26 (81.3%) were males. The median body mass index was 27.6 Kg/m2 and blood pressure was 140/80 mmHg. The median HbA1c level at baseline was 7.2%. At baseline, all the patients were on stable dose angiotensin receptor blockers and dapagliflozin. After a median follow-up of 285 days, the SCr (baseline: 2.11 mg/dL to 2.33 mg/dL at latest follow-up) and serum potassium (baseline: 4.5 mEq/L to 4.73 mEq/L at latest follow-up) had remained stable. The median levels of UACR increased non-significantly from 1120 mg/g to 1611.5 mg/g (p=0.655). No significant adverse events were identified in any of the patients. Three (9.7%) patients had developed increased serum potassium levels ≥5.5 mEq/L.
Conclusions:
In the short-term follow-up, finrenone was well tolerated. Proteinuria reduction was not seen in our study probably due to short follow up and small sample size. Hyperkalemia was evident in 9.7% of patients. In future, large, prospective studies are necessary to confirm these findings in our population.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.