Usage of Finerenone in Patients with Chronic Kidney Disease and Type 1 Diabetes
|
Reviewed & Translated by Dat Tien Nguyen, B.A, ScM.
|
Posted on March 25th, 2026
|
Previous study had found that overactivation of the mineralocorticoid receptor can lead to increased water and salt retention. Besides the negative effects on the kidney and cardiovascular system, it is also associated with proinflammatory and profibrotic pathways. A study that was recently published in the New England Medical Journal, investigated the usage of finerenone to manage kidney disease in patients with type 1 diabetes and chronic kidney disease.
Funding Source(s): Bayer
The phase 3 clinical study included 242 participants who had been diagnosed with type 1 diabetes and chronic kidney disease. These patients had an average urinary albumin-to-creatinine ratio of around 500, and an average estimated glomerular filtration rate of around 59. To manage their kidney disease, angiotensin-receptor blocker was used by around 52% of the cohort; ACE inhibitor and diuretic was used by around 45% and 36%, respectively.
The patients were randomly assigned to be treated with either placebo or finerenone at a daily dose of either 10 or 20 mg. Finerenone is a nonsteroidal mineralocorticoid receptor antagonist that blocks the effect of aldosterone, which lowers the rate of mineralocorticoid retention. After 6 months of treatment, the researchers found that finerenone reduced the urinary albumin-to-creatinine ratio by 34%, which is significantly more significant than the 12% reduction observed in the placebo group. However, finerenone caused a reduction in glomerular filtration rate. The author noted that the result is consistent with previously observed hemodynamic changes caused by other therapies. Nonetheless, future studies should be conducted to evaluate the long-term effects of finerenone, with enough participants to measure this effect with more statistical accuracy.
Funding Source(s): Bayer
The phase 3 clinical study included 242 participants who had been diagnosed with type 1 diabetes and chronic kidney disease. These patients had an average urinary albumin-to-creatinine ratio of around 500, and an average estimated glomerular filtration rate of around 59. To manage their kidney disease, angiotensin-receptor blocker was used by around 52% of the cohort; ACE inhibitor and diuretic was used by around 45% and 36%, respectively.
The patients were randomly assigned to be treated with either placebo or finerenone at a daily dose of either 10 or 20 mg. Finerenone is a nonsteroidal mineralocorticoid receptor antagonist that blocks the effect of aldosterone, which lowers the rate of mineralocorticoid retention. After 6 months of treatment, the researchers found that finerenone reduced the urinary albumin-to-creatinine ratio by 34%, which is significantly more significant than the 12% reduction observed in the placebo group. However, finerenone caused a reduction in glomerular filtration rate. The author noted that the result is consistent with previously observed hemodynamic changes caused by other therapies. Nonetheless, future studies should be conducted to evaluate the long-term effects of finerenone, with enough participants to measure this effect with more statistical accuracy.