Efficacy and safety of finerenone in non-diabetic CKD patients: a single-center, real-world, retrospective study

BMC Nephrol. 2025 Jul 1;26(1):323. doi: 10.1186/s12882-025-04241-w.

Abstract

Background: Finerenone, a novel non-steroidal mineralocorticoid receptor antagonist, has shown promising efficacy and safety profiles in the management of chronic kidney disease (CKD) associated with type 2 diabetes mellitus (T2DM). However, evidence for its role in non-diabetic CKD patients require further investigation.

Methods: This retrospective, real-world study involved non-diabetic CKD patients from April 2023 to June 2024. Participants received finerenone alongside standard CKD treatment. Primary clinical results included changes in the urinary albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), and serum potassium (sK+) levels. The data were collected initially and during follow-ups at 1, 3, 6, and 12 months.

Results: In total, 37 non-diabetic CKD patients were included in the population; 21 individuals (56.8%) were male, and the mean age was 48.84 ± 14.69 years. During the follow-up, there was a notable decrease in UACR, with a median reduction of 664.95 mg/g (IQR, 196.60-1226.70, P = 0.002). The baseline average eGFR was 70.80 ± 27.97 mL/min/1.73m2, with no notable alterations observed during the follow-up (P > 0.05). In terms of safety analysis, the sK + levels were within the 3.5-5.5 mmol/L range, with no significant difference from the baseline (P > 0.05). No patients discontinued treatment or were hospitalized because of hyperkalemia.

Conclusion: Real-world practice indicates that finerenone is effective and safe for non-diabetic CKD patients, but further large-scale, prospective studies are needed to confirm these findings.

Keywords: Chronic kidney disease; Finerenone; Non-diabetic.

MeSH terms

  • Adult
  • Aged
  • Albuminuria / urine
  • Creatinine / urine
  • Female
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Male
  • Middle Aged
  • Mineralocorticoid Receptor Antagonists* / adverse effects
  • Mineralocorticoid Receptor Antagonists* / therapeutic use
  • Naphthyridines* / adverse effects
  • Naphthyridines* / therapeutic use
  • Potassium / blood
  • Renal Insufficiency, Chronic* / drug therapy
  • Renal Insufficiency, Chronic* / urine
  • Retrospective Studies
  • Treatment Outcome

Substances

  • finerenone
  • Mineralocorticoid Receptor Antagonists
  • Naphthyridines
  • Creatinine
  • Potassium