IMPACT OF FINERENONE ON CHRONIC KIDNEY DISEASE (CKD) ASSOCIATED WITH TYPE 2 DIABETES AND ITS CARDIOVASCULAR OUTCOMES: A SYSTEMATIC REVIEW

 

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IMPACT OF FINERENONE ON CHRONIC KIDNEY DISEASE (CKD) ASSOCIATED WITH TYPE 2 DIABETES AND ITS CARDIOVASCULAR OUTCOMES: A SYSTEMATIC REVIEW

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Angelina
Thang
Angelina Thang angelinathang573@gmail.com Universitas Pelita Harapan Faculty of Medicine Tangerang Indonesia *
Gracia Lady Samuel graciasamuel072006@gmail.com Universitas Pelita Harapan Faculty of Medicine Tangerang Indonesia -
Vanessa Gloria Christanti Vanes.gc16@gmail.com Universitas Pelita Harapan Faculty of Medicine Tangerang Indonesia -
Jason Michael Prawira jasonmp9924@gmail.com Universitas Pelita Harapan Faculty of Medicine Tangerang Indonesia -
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Chronic Kidney Disease (CKD) is a devastating complications such as cardiovascular disease, heart failure and stroke affecting up to 40% of individuals with Type 2 Diabetes (T2D), significantly increasing their risk of progression to kidney failure and critically elevating their risk of cardiovascular (CV) morbidity and mortality. Finerenone, a novel non-steroidal, selective mineralocorticoid receptor antagonist, was developed to specifically address this residual cardiorenal risk. This analysis aims to synthesize current clinical evidence regarding the impact of finerenone on slowing CKD progression and improving cardiovascular outcomes in this high-risk patient population.

This review utilizes the following keywords “Chronic Kidney Disease (CKD)” and “Finerenone”. On 25th of September 2025, 2 researchers obtained data from multiple databases such as PubMed Central, New England Journal Of Medicine (NEJM), and PubMed. The studies were analyzed and extracted according to the inclusion criteria of patients with Chronic Kidney Disease associated with Type 2 Diabetes and cardiovascular conditions and clinical trials from the past 5 years. Meta-analyses, systematic reviews, animal studies and studies on children were excluded to ensure that a relevant analysis was produced. Primary endpoints included are the drug's ability to prevent major cardiac events, to measure the drug's ability to protect kidney function, assess the drug's risks and side effects and the resulting rate of permanent treatment discontinuation. Qualified studies were assessed using the RoB 2.0 tool to ensure its relevance.

3 randomized controlled trials out of 10 were identified, with a total of 19,104 participants. Based on the RoB 2.0 tool, some of the data specifics were missing and follow up information was not clearly stated such as how many participants lost during follow-ups. Despite this, the 3 studies showed that the Finerenone drug supported the lowering of incidence of hospitalization caused by heart failure. However, in contrast, it caused a negative renal outcome where eGFR decreased by more than 40%. In addition to that, there were concerns in Finerenone causing hyperkalemia (high potassium levels in blood) and studies prove that the incidence of hyperkalemia-related discontinuation of the trial regimen was higher with finerenone (1.2%) than with placebo (0.4%). These outcomes greatly highlight the impacts of Finerenone on Chronic Kidney Disease along with Cardiovascular issues.

Finerenone has shown significant contribution in reducing Cardiovascular Death, Chronic Kidney Disease and Type 2 Diabetes. While it demonstrates sustained benefits, further studies are needed to assess its cost-effectiveness in real-world settings and efficacy in finerenone and placebo. 

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