Finerenone Shows Potential to Preserve Kidney Function in Glomerular Diseases: FIND-CKD trial analysis
Chronic Kidney Disease
Australia: An exploratory analysis has found that finerenone slowed the decline in kidney function, reduced albuminuria, and lowered the risk of kidney failure or substantial loss of kidney function in patients with glomerular diseases. These findings suggest that finerenone may play an important role in protecting kidney health and preserving renal function in this patient population.
The findings are from a study published in JAMA by Brendon L. Neuen and colleagues from The George Institute for Global Health and collaborating institutions.
Glomerular diseases are a major cause of chronic kidney disease and kidney failure worldwide. While finerenone has shown kidney-protective benefits in certain CKD populations, its effects in patients with glomerular diseases have not been well established.
To evaluate its efficacy, researchers conducted a prespecified exploratory analysis of a phase 3 randomized, double-blind, placebo-controlled trial across 24 countries and regions. Adults with nondiabetic CKD and elevated urinary albumin levels were randomized to receive finerenone (10 mg or 20 mg daily) or placebo.
Of the 1,584 participants enrolled in the trial, 903 had glomerular diseases, including immunoglobulin A nephropathy (46.1%), focal segmental glomerulosclerosis (23.8%), and membranous nephropathy (10.0%). The mean age was 51 years, and 61.9% of participants were Asian.
The trial revealed the following findings:
- Finerenone slowed the decline in kidney function compared with placebo in patients with chronic kidney disease due to glomerular diseases.
- Over a follow-up period of up to 32 months, the annual rate of eGFR decline was reduced by 0.73 mL/min/1.73 m² per year with finerenone compared with placebo.
- The total eGFR slope was −3.50 mL/min/1.73 m² per year in the finerenone group versus −4.23 mL/min/1.73 m² per year in the placebo group.
- Finerenone reduced albuminuria by 42% at 12 months compared with placebo.
- Treatment with finerenone was associated with a 26% lower risk of kidney failure or a sustained decline of at least 40% in eGFR compared with placebo (hazard ratio 0.74).
- Rates of kidney failure or sustained ≥40% eGFR decline were 7.42 events per 100 patient-years in the finerenone group compared with 9.60 events per 100 patient-years in the placebo group.
- The kidney-protective benefits of finerenone were generally consistent across different glomerular disease subtypes.
The authors noted that the study was an exploratory subgroup analysis and was not powered to evaluate kidney outcomes within individual glomerular disease subtypes. Additionally, some participants lacked biopsy-confirmed diagnoses, and patients receiving immunosuppressive therapy or those with lupus nephritis and ANCA-associated vasculitis were excluded, which may limit the generalizability of the findings.
The researchers concluded that finerenone slowed the decline in kidney function, reduced albuminuria, and lowered the risk of kidney failure or substantial loss of kidney function in patients with CKD due to glomerular diseases. The consistent benefits across disease subtypes suggest a potential role for finerenone as a kidney-protective therapy in this high-risk population.
Reference:
Neuen BL, Perkovic V, Agarwal R, et al. Finerenone in Patients With Chronic Kidney Disease Due to Glomerular Diseases: A Randomized Clinical Trial. JAMA. Published online June 05, 2026. doi:10.1001/jama.2026.9923
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