Association of finerenone with prognosis and safety in diabetic kidney disease patients: an undated meta-analysis based on four RCTs
BackgroundAlthough current guidelines have recommended finerenone as a first-line agent for patients with diabetic kidney disease (DKD), it is unclear what effect finerenone has on all-cause and cardiovascular mortality. This study aimed to assess the impact of finerenone on the prognosis and safety...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1594202/full |
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| author | Zixuan Zhang Fan Zhang Yan Bai Jiao Li Yifei Zhong |
| author_facet | Zixuan Zhang Fan Zhang Yan Bai Jiao Li Yifei Zhong |
| author_sort | Zixuan Zhang |
| collection | DOAJ |
| description | BackgroundAlthough current guidelines have recommended finerenone as a first-line agent for patients with diabetic kidney disease (DKD), it is unclear what effect finerenone has on all-cause and cardiovascular mortality. This study aimed to assess the impact of finerenone on the prognosis and safety of patients with DKD.MethodsA systematic search was performed in PubMed, Embase, Scopus, and Web of Science. We included randomized controlled trials involving patients diagnosed with DKD that had finerenone versus placebo. The number of deaths, including any cause and cardiovascular causes, hyperkalemia, and adverse events, were collected for the finerenone and placebo groups. Data were summarized as risk ratio (RR) with 95% confidence interval (95% CI).ResultsFour trials (13,943 participants) were included in the meta-analysis. Results of the restricted maximum likelihood-adjusted random-effects model showed that finerenone was associated with a reduced risk of all-cause (RR: 0.894; 95% CI 0.802–0.998) and cardiovascular mortalities (RR: 0.824; 95% CI 0.685–0.990) in DKD patients. Finerenone predisposed to hyperkalemia compared with placebo (RR: 2.280; 95% CI 1.937–2.682).ConclusionThis meta-analysis provides key information on the prognosis and safety of finerenone in DKD patients. These results help to supplement the clinical evidence for finerenone.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, CRD42023463227. |
| format | Article |
| id | doaj-art-79c3190fd1ab41039dfd19387fa365d3 |
| institution | Kabale University |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj-art-79c3190fd1ab41039dfd19387fa365d32025-08-20T03:30:37ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.15942021594202Association of finerenone with prognosis and safety in diabetic kidney disease patients: an undated meta-analysis based on four RCTsZixuan ZhangFan ZhangYan BaiJiao LiYifei ZhongBackgroundAlthough current guidelines have recommended finerenone as a first-line agent for patients with diabetic kidney disease (DKD), it is unclear what effect finerenone has on all-cause and cardiovascular mortality. This study aimed to assess the impact of finerenone on the prognosis and safety of patients with DKD.MethodsA systematic search was performed in PubMed, Embase, Scopus, and Web of Science. We included randomized controlled trials involving patients diagnosed with DKD that had finerenone versus placebo. The number of deaths, including any cause and cardiovascular causes, hyperkalemia, and adverse events, were collected for the finerenone and placebo groups. Data were summarized as risk ratio (RR) with 95% confidence interval (95% CI).ResultsFour trials (13,943 participants) were included in the meta-analysis. Results of the restricted maximum likelihood-adjusted random-effects model showed that finerenone was associated with a reduced risk of all-cause (RR: 0.894; 95% CI 0.802–0.998) and cardiovascular mortalities (RR: 0.824; 95% CI 0.685–0.990) in DKD patients. Finerenone predisposed to hyperkalemia compared with placebo (RR: 2.280; 95% CI 1.937–2.682).ConclusionThis meta-analysis provides key information on the prognosis and safety of finerenone in DKD patients. These results help to supplement the clinical evidence for finerenone.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, CRD42023463227.https://www.frontiersin.org/articles/10.3389/fmed.2025.1594202/fulldiabetic kidney diseasefinerenonemortalitysystematic reviewmeta-analysis |
| spellingShingle | Zixuan Zhang Fan Zhang Yan Bai Jiao Li Yifei Zhong Association of finerenone with prognosis and safety in diabetic kidney disease patients: an undated meta-analysis based on four RCTs Frontiers in Medicine diabetic kidney disease finerenone mortality systematic review meta-analysis |
| title | Association of finerenone with prognosis and safety in diabetic kidney disease patients: an undated meta-analysis based on four RCTs |
| title_full | Association of finerenone with prognosis and safety in diabetic kidney disease patients: an undated meta-analysis based on four RCTs |
| title_fullStr | Association of finerenone with prognosis and safety in diabetic kidney disease patients: an undated meta-analysis based on four RCTs |
| title_full_unstemmed | Association of finerenone with prognosis and safety in diabetic kidney disease patients: an undated meta-analysis based on four RCTs |
| title_short | Association of finerenone with prognosis and safety in diabetic kidney disease patients: an undated meta-analysis based on four RCTs |
| title_sort | association of finerenone with prognosis and safety in diabetic kidney disease patients an undated meta analysis based on four rcts |
| topic | diabetic kidney disease finerenone mortality systematic review meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1594202/full |
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