Year: 2026
Type: article
Abstract: Introduction: The nonsteroidal mineralocorticoid receptor antagonist finerenone reduces urine albumin-to-creatinine ratio (UACR) in people with type 1 diabetes (T1D) and chronic kidney disease (CKD). This prespecified analysis evaluated acute changes in estimated glomerular filtration rate (eGFR) with finerenone and their impact on safety. Methods: ; UACR ≥ 200 to < 5000 mg/g) receiving stable renin-angiotensin system (RAS) inhibition were randomized 1:1 to finerenone or placebo. The primary outcome was acute change in eGFR (from baseline to month 1), termed "eGFR dip." Reversibility of eGFR change was assessed from end of the treatment (month 6) to follow-up (month 7). Change in eGFR was assessed across eGFR dip subgroups (eGFR > 0 to ≤ 10% decline, > 10% decline, and ≥ 0% increase) and prespecified characteristics (baseline eGFR, UACR, history of cardiovascular disease [CVD], and diuretic use). Results: = 0.049]). Placebo-corrected eGFR increased during the washout period across the groups. Acute eGFR changes did not differ according to prespecified characteristics. The incidence of treatment-emergent adverse events (TEAEs) was comparable across eGFR dip subgroups in both the treatment groups. Greater declines in eGFR were associated with greater reductions in UACR at month 3. Conclusion: In people with T1D and CKD, finerenone induced an acute eGFR dip that was well tolerated without unexpected safety signals.
Source: Kidney International Reports
Authors: David Z.I. Cherney, Tae Won Yi, Hiddo J.L. Heerspink, Linong Ji, Janet B. McGill, Peter Rossing, Katherine R. Tuttle, Jesper N. Bech, Paolo Fiorina, Albert Power, Karoline Schousboe, Nicholas M. Selby, Emanuela Setola, J. David Smeijer, Robert Lawatscheck, Meike Brinker, Julie Russell, Patrick Schloemer, Per-Henrik Groop
Institutions: University Health Network, University of Toronto, Toronto General Hospital, University Medical Center Groningen, University of Groningen, UNSW Sydney, The George Institute for Global Health, Peking University People's Hospital, Washington University in St. Louis, University of Copenhagen, Steno Diabetes Center Copenhagen, University of Washington, Inland Northwest Health Services, Aarhus University, Regionshospitalet Herning, University of Milan, ASST Fatebenefratelli Sacco, North Bristol NHS Trust, University of Bristol, Odense University Hospital, University of Nottingham, Royal Derby Hospital, IRCCS Ospedale San Raffaele, Bayer (Germany), Bayer (United Kingdom), University of Helsinki, Helsinki University Hospital
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,800
Funders: American Society of Nephrology, Amgen, Bristol-Myers Squibb, Eli Lilly and Company, Pfizer, AstraZeneca, Bayer, Sanofi, Gilead Sciences, Alexion Pharmaceuticals, Oregon Health and Science University, University of Miami, Northwestern University, University of Missouri, University of Chicago, Cleveland Clinic, Joslin Diabetes Center, CSL Behring, NHS Greater Glasgow and Clyde, MedStar Health Research Institute, Touro University California, MannKind Corporation, Seoul National University, Yonsei University, Novo Nordisk, Seoul National University Hospital, North Bristol NHS Trust, Korea University Anam Hospital, Barts Health NHS Trust, National Institutes of Health, Samsung, Feinberg School of Medicine, Leonard M. Miller School of Medicine, Washington University School of Medicine in St. Louis, Leonard M. Miller School of Medicine, University of Miami
OpenAlex ID: W7213393978