Finerenone slows kidney decline in non-diabetic CKD trial
A 1,584-person international study found finerenone slowed kidney function loss in chronic kidney disease patients without diabetes.
By Lucas Ferreira · Science & Environment Writer
3 min read
Finerenone slowed the decline of kidney function in adults with chronic kidney disease who did not have diabetes, according to an international clinical trial published in the New England Journal of Medicine. The finding could widen treatment options for a large group of CKD patients who, according to the University Medical Center Groningen, have had few choices beyond standard care.
The FIND-CKD study was led by clinical pharmacologist Hiddo Lambers Heerspink of the University Medical Center Groningen, the institution said. Researchers enrolled 1,584 adults with chronic kidney disease who had reduced kidney function and elevated protein in their urine, a marker the Groningen team described as an early sign of kidney damage.
Participants were randomly assigned to take finerenone once a day or receive a placebo, according to the study summary from the University Medical Center Groningen. Both groups also continued standard treatment with ACE inhibitors or angiotensin receptor blockers.
Kidney function declined more slowly
Researchers tracked kidney function using estimated glomerular filtration rate, or eGFR, which reflects how well the kidneys filter waste from the blood. Over a 2.5-year follow-up period for that measure, the finerenone group had a statistically significant slower decline in eGFR than the placebo group, according to the Groningen team.
Lambers Heerspink said the difference was not limited to statistical significance and was meaningful for clinical care, the University Medical Center Groningen reported. The study followed patients for an average of a little more than three years.
The drug also was linked to fewer serious kidney and cardiovascular outcomes, according to the study summary. Major kidney events, hospitalization for heart failure and death from cardiovascular disease occurred in 13.9% of patients assigned to finerenone, compared with 16.9% of those assigned to placebo, which Lambers Heerspink described as about a 23% lower risk.
Protein levels in urine fell
The Groningen team said finerenone also reduced protein in the urine, another measure tied to kidney prognosis. Average urinary protein levels fell by more than 41% in the finerenone group and by about 9% in the placebo group, according to Lambers Heerspink.
More than half of patients taking finerenone had at least a 30% drop in urinary protein, the University Medical Center Groningen said. Lambers Heerspink said that scale of reduction points to a more favorable outlook for kidney health.
Earlier large trials of finerenone mainly studied people with type 2 diabetes, according to the Groningen team. The new results extend evidence of benefit to CKD patients without diabetes, a group Lambers Heerspink said makes up more than half of CKD patients worldwide.
The University Medical Center Groningen said chronic kidney disease affects an estimated 800 million adults worldwide. Researchers also reported that finerenone was safe during the study.
Lambers Heerspink said the findings give physicians another possible way to preserve kidney function and reduce kidney and cardiovascular complications in non-diabetic CKD patients. The journal reference identifies the paper as “Finerenone in Persons with Chronic Kidney Disease without Diabetes,” with DOI 10.1056/NEJMoa2604625.
This story draws on original reporting from ScienceDaily.