Effectiveness and safety of finerenone in diabetic kidney disease patients: a real-world observational study from China

Aims Finerenone has been approved for treating diabetic kidney disease (DKD) with reducing cardiorenal risk. Real-world data on finerenone treatment for the management of DKD are presently lacking. This study aimed to investigate the effect of finerenone on the renal parameters of the Chinese DKD po...

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Main Authors: Jingying Zhou, Le Kang, Chenjie Gu, Xinwei Li, Xianan Guo, Ming Fang
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2024.2400541
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author Jingying Zhou
Le Kang
Chenjie Gu
Xinwei Li
Xianan Guo
Ming Fang
author_facet Jingying Zhou
Le Kang
Chenjie Gu
Xinwei Li
Xianan Guo
Ming Fang
author_sort Jingying Zhou
collection DOAJ
description Aims Finerenone has been approved for treating diabetic kidney disease (DKD) with reducing cardiorenal risk. Real-world data on finerenone treatment for the management of DKD are presently lacking. This study aimed to investigate the effect of finerenone on the renal parameters of the Chinese DKD population in the real-world medical setting for the first time, especially in combination with renin–angiotensin system inhibitors (RASi) and sodium-glucose cotransporter 2 inhibitors (SGLT2i).Methods Forty-two DKD patients were selected and completed a 6-month finerenone treatment. Renal parameters and adverse effects were collected at every visit.Results The median urine albumin-to-creatinine ratio (UACR) was 1426.11 (755.42, 3638.23) mg/g. Among them, the proportion of patients with a UACR of 300–5000 mg/g was 76.2%, and the proportion of patients with a UACR of >5000 mg/g was 14.3%. The median estimated glomerular filtration rate (eGFR) was 54.50 (34.16, 81.73) mL/min/1.73 m2. Finerenone decreased the UACR significantly throughout the study period (p < .05). The maximal decline of UACR at month 6 was 73%. Moreover, the proportion of patients with a 30% or greater reduction in UACR was 68.42% in month 6. There was a smaller decline (9–11%) in the eGFR after initiating finerenone (p > .05). One patient each discontinued finerenone due to hyperkalemia (2.4%) and acute kidney injury (2.4%). No patient reported hypotension, breast pain, and gynecomastia.Conclusions This study from China first demonstrated finerenone decreased UACR with manageable safety in real-world DKD treatment. A triple regimen of RASi, SGLT2i, and finerenone may be a promising treatment strategy for lowering albuminuria and reducing hyperkalemia risk in advanced DKD patients.
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spelling doaj-art-cb6c4f3968564e3eab59de8f789534c32025-08-20T03:21:42ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146210.1080/0886022X.2024.2400541Effectiveness and safety of finerenone in diabetic kidney disease patients: a real-world observational study from ChinaJingying Zhou0Le Kang1Chenjie Gu2Xinwei Li3Xianan Guo4Ming Fang5Department of Nephrology, The First Affiliated Hospital of Dalian Medical University, Renal Translational Medicine Center of Liaoning Province, Dalian, ChinaMedical College of Dalian University, Dalian, ChinaDepartment of Nephrology, The First Affiliated Hospital of Dalian Medical University, Renal Translational Medicine Center of Liaoning Province, Dalian, ChinaDepartment of Nephrology, The First Affiliated Hospital of Dalian Medical University, Renal Translational Medicine Center of Liaoning Province, Dalian, ChinaDepartment of Nephrology, The First Affiliated Hospital of Dalian Medical University, Renal Translational Medicine Center of Liaoning Province, Dalian, ChinaDepartment of Nephrology, The First Affiliated Hospital of Dalian Medical University, Renal Translational Medicine Center of Liaoning Province, Dalian, ChinaAims Finerenone has been approved for treating diabetic kidney disease (DKD) with reducing cardiorenal risk. Real-world data on finerenone treatment for the management of DKD are presently lacking. This study aimed to investigate the effect of finerenone on the renal parameters of the Chinese DKD population in the real-world medical setting for the first time, especially in combination with renin–angiotensin system inhibitors (RASi) and sodium-glucose cotransporter 2 inhibitors (SGLT2i).Methods Forty-two DKD patients were selected and completed a 6-month finerenone treatment. Renal parameters and adverse effects were collected at every visit.Results The median urine albumin-to-creatinine ratio (UACR) was 1426.11 (755.42, 3638.23) mg/g. Among them, the proportion of patients with a UACR of 300–5000 mg/g was 76.2%, and the proportion of patients with a UACR of >5000 mg/g was 14.3%. The median estimated glomerular filtration rate (eGFR) was 54.50 (34.16, 81.73) mL/min/1.73 m2. Finerenone decreased the UACR significantly throughout the study period (p < .05). The maximal decline of UACR at month 6 was 73%. Moreover, the proportion of patients with a 30% or greater reduction in UACR was 68.42% in month 6. There was a smaller decline (9–11%) in the eGFR after initiating finerenone (p > .05). One patient each discontinued finerenone due to hyperkalemia (2.4%) and acute kidney injury (2.4%). No patient reported hypotension, breast pain, and gynecomastia.Conclusions This study from China first demonstrated finerenone decreased UACR with manageable safety in real-world DKD treatment. A triple regimen of RASi, SGLT2i, and finerenone may be a promising treatment strategy for lowering albuminuria and reducing hyperkalemia risk in advanced DKD patients.https://www.tandfonline.com/doi/10.1080/0886022X.2024.2400541Finerenonediabetic kidney diseasealbuminuriahyperkalemia
spellingShingle Jingying Zhou
Le Kang
Chenjie Gu
Xinwei Li
Xianan Guo
Ming Fang
Effectiveness and safety of finerenone in diabetic kidney disease patients: a real-world observational study from China
Renal Failure
Finerenone
diabetic kidney disease
albuminuria
hyperkalemia
title Effectiveness and safety of finerenone in diabetic kidney disease patients: a real-world observational study from China
title_full Effectiveness and safety of finerenone in diabetic kidney disease patients: a real-world observational study from China
title_fullStr Effectiveness and safety of finerenone in diabetic kidney disease patients: a real-world observational study from China
title_full_unstemmed Effectiveness and safety of finerenone in diabetic kidney disease patients: a real-world observational study from China
title_short Effectiveness and safety of finerenone in diabetic kidney disease patients: a real-world observational study from China
title_sort effectiveness and safety of finerenone in diabetic kidney disease patients a real world observational study from china
topic Finerenone
diabetic kidney disease
albuminuria
hyperkalemia
url https://www.tandfonline.com/doi/10.1080/0886022X.2024.2400541
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