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Preparing your E-Poster
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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Abstract titles should be brief and reflect the content of the abstract.
Diabetic kidney disease (DKD) remains a leading cause of end-stage renal disease worldwide. Finerenone, a non-steroidal mineralocorticoid receptor antagonist, has demonstrated renal and cardiovascular benefits in randomized controlled trials. However, real-world evidence in Asian populations, particularly in Japan, is limited. This study aims to evaluate the renal effects of finerenone in Japanese patients with DKD using the J-DREAMS database, a nationwide real-world registry.
We conducted a retrospective cohort analysis of patients with type 2 diabetes mellitus (T2DM) and DKD who initiated finerenone therapy, identified from the J-DREAMS database between June 1, 2021, and March 31, 2025. Patients undergoing dialysis or kidney transplantation were excluded. Renal function was assessed using estimated glomerular filtration rate (eGFR), and albuminuria was evaluated via urinary albumin-to-creatinine ratio (UACR). Changes in eGFR slope and UACR were analyzed over a 12-month period, stratified by CKD stages (G1–G4 and G2–G4 subsets). Statistical comparisons were performed using linear mixed models, and 95% confidence intervals (CI) were calculated for UACR changes.
Among 24,868 patients with T2DM, 482 individuals initiated finerenone therapy. Their baseline characteristics were as follows: mean age 67.7 ± 12.5 years, 29.3% female, diabetes duration 18.9 ± 11.7 years, HbA1c 7.2 ± 1.1%, eGFR 51.7 ± 24.2 ml/min/1.73m², and UACR 810 ± 1485 mg/g creatinine. 32 (6.6%), 107 (22.2%), 258 (53.5%), and 78 (16.2%) patients were classified as CKD stages G1, G2, G3, and G4, respectively. Compared to the overall T2DM cohort, finerenone initiators were older, predominantly male, had a longer duration of diabetes, lower eGFR, and higher UACR.
eGFR slope:
From 12 months prior to baseline:
G1–G4: −2.19 ml/min/1.73m²/year
G2–G4: −2.57 ml/min/1.73m²/year
From baseline to 12 months post-finerenone:
G1–G4: −3.13 ml/min/1.73m²/year
G2–G4: −1.35 ml/min/1.73m²/year
UACR reduction:
G1–G4:
0 to 4 months: −0.151 (95% CI: −0.219 to −0.082)
0 to 9 months: −0.276 (95% CI: −0.340 to −0.213)
0 to 12 months: −0.244 (95% CI: −0.315 to −0.173)
G2–G4:
0 to 4 months: −0.132 (95% CI: −0.205 to −0.060)
0 to 9 months: −0.238 (95% CI: −0.307 to −0.169)
0 to 12 months: −0.233 (95% CI: −0.310 to −0.156)
These findings suggest a stabilization or attenuation of renal function decline in G2–G4 patients following finerenone initiation, with consistent reductions in albuminuria across subgroups.
This real-world analysis from the J-DREAMS database supports the renal protective effects of finerenone in Japanese patients with DKD, particularly in those with moderate-to-advanced CKD stages. The observed improvements in UACR and eGFR slope warrant further investigation in a full cohort analysis and may inform clinical decision-making in Asian populations.
