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Finerenone is effective and safe in chronic kidney disease (CKD) with type 2 diabetes mellitus (T2DM) in phase III clinical trials. However, no data from clinical trials and real-world is available on the effectiveness of finerenone in CKD patients without diabetes mellitus(DM).
CKD patients without DM were enrolled in this study from December 2022 to May 2023. Apart from standard CKD treatment, participants were treated with Finerenone. Evaluations 24-hour urinary protein (UTP) ,estimated glomerular filtration rate (eGFR), and serum potassium (sK+) were conducted on a monthly basis for 5 months following enrollment.
A total of 43 patients were enrolled and baseline characteristics were summarized in Table1. The mean age of the participants was 50.98±13.00, with 30 (62.5%) being male. Additionally, 46.5% (20) of the patients were diagnosed with membranous nephropathy. 24h UTP showed a significant reduction through follow-up with a median reduction of 2.76g (IQR, 0.2015-2.609, P<0.01), representing a percent change of 60.86% (IQR, 35.625%-87.062%) as shown in Figure 1a. While the decline of eGFR showed no difference through follow-up (Figure 1b). For safety analysis, the levels of serum potassium (sK+) remained within the range of 3.5-5.0 mmol/L with only minor fluctuations compared to baseline (Figure 1c), which prevented rehospitalization due to hyperkalemia.
The reduction in proteinuria among patients who used Finerenone was found to be statistically significant. Furthermore, the minimal impact on hyperkalemia suggested both the safety and effectiveness of Finerenone in treating patients with CKD without DM. However, sample size in this study was small. Thus, further large-scale investigations will be necessary to validate and strengthen the findings.