Finerenone in Patients with Nondiabetic Chronic Kidney Disease—A Retrospective Study
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Albuminuria Measurement
2.3. Glomerular Filtration Rate Estimation
2.4. Physical Examination
2.5. End Points
2.6. Statistical Analysis
3. Results
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Marcath, L.A. Finerenone. Clin. Diabetes 2021, 39, 331–332. [Google Scholar] [CrossRef]
- Stompór, T.; Adamczak, M.; Kurnatowska, I.; Naumnik, B.; Nowicki, M.; Tylicki, L.; Winiarska, A.; Krajewska, M. Pharmacological Nephroprotection in Non-Diabetic Chronic Kidney Disease—Clinical Practice Position Statement of the Polish Society of Nephrology. J. Clin. Med. 2023, 12, 5184. [Google Scholar] [CrossRef]
- Rico-Mesa, J.S.; White, A.; Ahmadian-Tehrani, A.; Anderson, A.S. Mineralocorticoid receptor antagonists: A comprehensive review of finerenone. Curr. Cardiol. Rep. 2020, 22, 140. [Google Scholar] [CrossRef]
- Kolkhof, P.; Jaisser, F.; Kim, S.-Y.; Filippatos, G.; Nowack, C.; Pitt, B. Steroidal and novel non-steroidal mineralocorticoid receptor antagonists in heart failure and cardiorenal diseases: Comparison at bench and bedside. Heart Fail. 2017, 243, 271–305. [Google Scholar]
- Marzolla, V.; Infante, M.; Armani, A.; Rizzo, M.; Caprio, M. Efficacy and safety of finerenone for treatment of diabetic kidney disease: Current knowledge and future perspective. Expert Opin. Drug Saf. 2022, 21, 1161–1170. [Google Scholar] [CrossRef] [PubMed]
- Bakris, G.L.; Agarwal, R.; Anker, S.D.; Pitt, B.; Ruilope, L.M.; Rossing, P.; Kolkhof, P.; Nowack, C.; Schloemer, P.; Joseph, A.; et al. Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes. N. Engl. J. Med. 2020, 383, 2219–2229. [Google Scholar] [CrossRef] [PubMed]
- Sato, N.; Ajioka, M.; Yamada, T.; Kato, M.; Myoishi, M.; Yamada, T.; Kim, S.-Y.; Nowack, C.; Kolkhof, P.; Shiga, T.; et al. A randomized controlled study of finerenone vs. eplerenone in Japanese patients with worsening chronic heart failure and diabetes and/or chronic kidney disease. Circ. J. 2016, 80, 1113–1122. [Google Scholar] [CrossRef]
- Mårup, F.H.; Thomsen, M.B.; Birn, H. Additive effects of dapagliflozin and finerenone on albuminuria in non-diabetic CKD: An open-label randomized clinical trial. Clin. Kidney J. 2024, 17, sfad249. [Google Scholar] [CrossRef]
- Sun, Y.; Ren, Y.; Lan, P.; Yu, X.; Feng, J.; Hao, D.; Xie, L. Clinico-pathological features of diabetic and non-diabetic renal diseases in type 2 diabetic patients: A retrospective study from a 10-year experience in a single center. Int. Urol. Nephrol. 2023, 55, 2303–2312. [Google Scholar] [CrossRef]
- Zeng, Y.Q.; Yang, Y.X.; Guan, C.J.; Guo, Z.W.; Li, B.; Yu, H.Y.; Chen, R.X.; Tang, Y.Q.; Yan, R. Clinical predictors for nondiabetic kidney diseases in patients with type 2 diabetes mellitus: A retrospective study from 2017 to 2021. BMC Endocr. Disord. 2022, 22, 168. [Google Scholar] [CrossRef]
- Grujicic, M.; Salapura, A.; Basta-Jovanovic, G.; Figurek, A.; Micic-Zrnic, D.; Grbic, A. Non-Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus-11-Year Experience from a Single Center. Med. Arch. 2019, 73, 87–91. [Google Scholar] [CrossRef]
- Arora, P.; Roychaudhury, A.; Pandey, R. Non-diabetic Renal Diseases in Patients with Diabetes Mellitus Clinicopathological Correlation. Indian J. Nephrol. 2020, 30, 295–300. [Google Scholar] [CrossRef] [PubMed]
- Wanner, C.; Schuchhardt, J.; Bauer, C.; Lindemann, S.; Brinker, M.; Kong, S.X.; Kleinjung, F.; Horvat-Broecker, A.; Vaitsiakhovich, T. Clinical characteristics and disease outcomes in non-diabetic chronic kidney disease: Retrospective analysis of a US healthcare claims database. J. Nephrol. 2022, 36, 45–54. [Google Scholar] [CrossRef] [PubMed]
- Ogi, M.; Seto, T.; Wakabayashi, Y. Prediction of microalbuminuria from proteinuria in chronic kidney disease due to non-diabetic lifestyle-related diseases: Comparison with diabetes. Clin. Exp. Nephrol. 2021, 25, 727–750. [Google Scholar] [CrossRef] [PubMed]
- Tang, W.H.; Hung, W.C.; Wang, C.P.; Wu, C.C.; Hsuan, C.F.; Yu, T.H.; Hsu, C.C.; Cheng, Y.A.; Chung, F.M.; Lee, Y.J.; et al. The Lower Limit of Reference of Urinary Albumin/Creatinine Ratio and the Risk of Chronic Kidney Disease Progression in Patients With Type 2 Diabetes Mellitus. Front. Endocrinol. 2022, 13, 858267. [Google Scholar] [CrossRef]
- Fernandez-Fernandez, B.; Sarafidis, P.; Kanbay, M.; Navarro-González, J.F.; Soler, M.J.; Górriz, J.L.; Ortiz, A. SGLT2 inhibitors for non-diabetic kidney disease: Drugs to treat CKD that also improve glycaemia. Clin. Kidney J. 2020, 13, 728–733. [Google Scholar] [CrossRef]
- Podestà, M.A.; Sabiu, G.; Galassi, A.; Ciceri, P.; Cozzolino, M. SGLT2 Inhibitors in Diabetic and Non-Diabetic Chronic Kidney Disease. Biomedicines 2023, 11, 279. [Google Scholar] [CrossRef]
- Agarwal, R.; Joseph, A.; Anker, S.D.; Filippatos, G.; Rossing, P.; Ruilope, L.M.; Pitt, B.; Kolkhof, P.; Scott, C.; Lawatscheck, R.; et al. Hyperkalemia Risk with Finerenone: Results from the FIDELIO-DKD Trial. J. Am. Soc. Nephrol. 2022, 33, 225–237. [Google Scholar] [CrossRef]
- Epstein, M.; Pecoits-Filho, R.; Clase, C.M.; Sood, M.M.; Kovesdy, C.P. Hyperkalemia with Mineralocorticoid Receptor Antagonist Use in People with CKD: Understanding and Mitigating the Risks. Clin. J. Am. Soc. Nephrol. 2022, 17, 455–457. [Google Scholar] [CrossRef]
- Agarwal, R.; Ruilope, L.M.; Ruiz-Hurtado, G.; Haller, H.; Schmieder, R.E.; Anker, S.D.; Filippatos, G.; Pitt, B.; Rossing, P.; Lambelet, M.; et al. Effect of finerenone on ambulatory blood pressure in chronic kidney disease in type 2 diabetes. J. Hypertens. 2023, 41, 295–302. [Google Scholar] [CrossRef]
- Shaikh, A.; Ray, J.; Campbell, K.N. Role of Finerenone in the Treatment of Diabetic Kidney Disease: Patient Selection and Clinical Perspectives. Ther. Clin. Risk Manag. 2022, 18, 753–760. [Google Scholar] [CrossRef]
- Sundström, J.; Bodegard, J.; Bollmann, A.; Vervloet, M.G.; Mark, P.B.; Karasik, A.; Taveira-Gomes, T.; Botana, M.; Birkeland, K.I.; Thuresson, M.; et al. Prevalence, outcomes, and cost of chronic kidney disease in a contemporary population of 2· 4 million patients from 11 countries: The CaReMe CKD study. Lancet Reg. Health–Eur. 2022, 20, 100438. [Google Scholar] [CrossRef] [PubMed]
- Goulooze, S.C.; Heerspink, H.J.L.; van Noort, M.; Snelder, N.; Brinker, M.; Lippert, J.; Eissing, T. Dose–Exposure–Response Analysis of the Nonsteroidal Mineralocorticoid Receptor Antagonist Finerenone on UACR and eGFR: An Analysis from FIDELIO-DKD. Clin. Pharmacokinet. 2022, 61, 1013–1025. [Google Scholar] [CrossRef] [PubMed]
- Theodorakopoulou, M.P.; Sarafidis, P. SGLT2 inhibitors and finerenone in non-diabetic CKD: A step into the (near) future? Clin. Kidney J. 2024, 17, sfad272. [Google Scholar] [CrossRef] [PubMed]
Total (N = 16) | |
---|---|
Demographics | |
Age, years | 38.5 (35–50) |
Sex, male | 9 (56.3%) |
BMI | 29.0 (27.2–30.0) |
Primary renal disease | |
IgA | 8 (50%) |
FSGS | 3 (18.8%) |
Others | 5 (31.3%) |
Blood pressure | |
Systolic BP | 131.5 (122.5–139.5) |
Diastolic BP | 79 (74.5–85) |
RAAS inhibitors | 16 (100%) |
SGLT2 inhibitors | 15 (93.8%) |
Diuretics | 3 (18.8%) |
Statin | 13 (81.3%) |
Potassium binders | 2 (12.5%) |
Immunosuppressants | 7 (43.8%) |
| 6 (37.5%) |
| 1 (6.3%) |
| 2 (12.5%) |
Baseline laboratory results | |
HbA1C (n = 14) | 5.7 (5.4–6.0) |
Creatinine | 120 (90.5–153) |
eGFR | 66 (47–82.5) |
UPCR (n = 15) | 1.4 (0.9–2.2) |
UACR (n = 12) | 90.0 (58.8–132.5) |
Potassium | 4 (3.8–4.4) |
Albumin | 43.5 (38.8–45.0) |
Hemoglobin | 14.5 (12.7–15.6) |
Total cholesterol | 4.7 (3.9–6.5) |
LDL | 2.8 (2.2–4.1) |
Finerenone treatment | |
Dosage | 10 (10–15) |
Blood pressure (n = 11) | |
Systolic BP | 117 (111–126) |
Diastolic BP | 72 (66–75) |
Adverse events | |
Any adverse event | 0 |
Post-treatment laboratory results | |
Creatinine (n = 12) | 119 (100.5–151) |
eGFR (n = 12) | 58 (46–76) |
UPCR (n = 10) | 0.4 (0.3–1.0) |
UACR (n = 8) | 39.3 (20.9–108.7) |
Potassium (n = 12) | 4.4 (4.0–4.5) |
Albumin (n = 12) | 41.7 (39.4–44.5) |
Hemoglobin (n = 12) | 13.9 (11.8–15.4) |
Total cholesterol (n = 6) | 4.9 (3.9–5.2) |
LDL (n = 6) | 2.5 (2.2–2.9) |
Pre-Treatment | Post-Treatment | p-Value | |
---|---|---|---|
Blood pressure (n = 11) | |||
Systolic BP | 131.5 (122.5–139.5) | 117 (111–126) | <0.01 |
Diastolic BP | 79 (74.5–85) | 72 (66–75) | 0.01 |
Laboratory results | |||
Creatinine (n = 12) | 120 (90.5–153) | 119 (100.5–151) | <0.01 |
eGFR (n = 12) | 66 (47–82.5) | 58 (46–76) | <0.01 |
UPCR (n = 10) | 1.4 (0.9–2.2) | 0.4 (0.3–1.0) | <0.01 |
UACR (n = 8) | 90.0 (58.8–132.5) | 39.3 (20.9–108.7) | 0.04 |
Potassium (n = 12) | 4 (3.8–4.4) | 4.4 (4.0–4.5) | 0.48 |
Albumin (n = 12) | 43.5 (38.8–45.0) | 41.7 (39.4–44.5) | 0.31 |
Hemoglobin (n = 12) | 14.5 (12.7–15.6) | 13.9 (11.8–15.4) | 0.08 |
Total cholesterol (n = 6) | 4.7 (3.9–6.5) | 4.9 (3.9–5.2) | 0.25 |
LDL (n = 6) | 2.8 (2.2–4.1) | 2.5 (2.2–2.9) | 0.17 |
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Albakr, R.B.; AlRowaie, F.; Sandokji, I.A.; Alhadlg, Y.A.; Almatham, K.; Albacker, A.B. Finerenone in Patients with Nondiabetic Chronic Kidney Disease—A Retrospective Study. Biomedicines 2025, 13, 2519. https://doi.org/10.3390/biomedicines13102519
Albakr RB, AlRowaie F, Sandokji IA, Alhadlg YA, Almatham K, Albacker AB. Finerenone in Patients with Nondiabetic Chronic Kidney Disease—A Retrospective Study. Biomedicines. 2025; 13(10):2519. https://doi.org/10.3390/biomedicines13102519
Chicago/Turabian StyleAlbakr, Rehab B., Fadel AlRowaie, Ibrahim A. Sandokji, Yazid A. Alhadlg, Khalid Almatham, and Abdulaziz B. Albacker. 2025. "Finerenone in Patients with Nondiabetic Chronic Kidney Disease—A Retrospective Study" Biomedicines 13, no. 10: 2519. https://doi.org/10.3390/biomedicines13102519
APA StyleAlbakr, R. B., AlRowaie, F., Sandokji, I. A., Alhadlg, Y. A., Almatham, K., & Albacker, A. B. (2025). Finerenone in Patients with Nondiabetic Chronic Kidney Disease—A Retrospective Study. Biomedicines, 13(10), 2519. https://doi.org/10.3390/biomedicines13102519