'Important new treatment option': Finerenone can slow kidney decline in patients without diabetes

A medication already used to treat diabetic kidney disease may soon help a far broader group of patients.

A new study, published in the peer-reviewed New England Journal of Medicine, suggests that the drug finerenone could benefit people with chronic kidney disease, or CKD, who do not have diabetes by slowing the loss of kidney function and reducing the chances of major complications.

What happened?

According to the WHO, roughly 674 million adults worldwide live with chronic kidney disease, a condition linked to kidney failure, heart-related complications, and earlier death. But for patients with CKD who are not diabetic, the range of available treatments has been relatively narrow.

Finerenone may help address that unmet need. The study suggesting this was led by University Medical Center Groningen clinical pharmacologist Hiddo Lambers Heerspink, per SciTechDaily.

The researchers studied 1,584 adults with CKD who did not have diabetes. All of them had reduced kidney function and elevated protein in the urine, both signs of kidney damage.

Participants stayed on standard treatment with an ACE inhibitor or angiotensin receptor blocker and received either finerenone or a placebo. They were then followed for a little more than three years on average.

The researchers found that the drug slows the decline in kidney functioning over a 2.5-year period and results in a serious decrease in kidney complications.

"In the finerenone group, 13.9% experienced such a complication, compared to 16.9% in the placebo group," Lambers Heerspink said. "That amounts to a reduction in risk of approximately 23%."

Why does it matter?

CKD can worsen with little warning. Many people do not notice symptoms until their kidneys are already significantly damaged.

By that point, the risks of hospitalization, heart failure, and premature death are much higher.

That is especially important because more than half of CKD patients worldwide do not have diabetes, even though many of the biggest finerenone studies so far have focused on people who do.

"Now it turns out the drug is also effective in people without diabetes, even though more than half of all CKD patients worldwide are non-diabetic," Lambers Heerspink said, per SciTechDaily.

The study also showed better urinary protein results, which can point to ongoing kidney damage. After six months, average protein in the urine had dropped by more than 41% in the finerenone group, compared with about 9% in the placebo group.

What's being done?

Researchers are building on existing kidney care rather than replacing it. In the trial, finerenone was added to standard medications used to protect kidney function and manage blood pressure, suggesting it could become another option for doctors treating CKD.

The study also found the drug was safe in this patient group, which could support broader use.

Even promising drugs are most effective when kidney disease is identified before it progresses too far.

"Finerenone could become an important new treatment option for people with chronic kidney disease who do not have diabetes," Lambers Heerspink said. "The drug offers a clear delay in the decline of kidney function on top of current standard care."

It may not change treatment overnight, but it could shape future care. 

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