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. 2025 Jul 1;26(1):323.
doi: 10.1186/s12882-025-04241-w.

Efficacy and safety of finerenone in non-diabetic CKD patients: a single-center, real-world, retrospective study

Yu Li #  1 , Jiaxing Feng #  2 , Xiaodan Guo  1 , Wusijie Zhang  3 , Ting Yang  3 , Tianjun Guan  1 , Bo Xu  4
Affiliations

Efficacy and safety of finerenone in non-diabetic CKD patients: a single-center, real-world, retrospective study

Yu Li et al. BMC Nephrol. .

Abstract

Background: Finerenone, a novel non-steroidal mineralocorticoid receptor antagonist, has shown promising efficacy and safety profiles in the management of chronic kidney disease (CKD) associated with type 2 diabetes mellitus (T2DM). However, evidence for its role in non-diabetic CKD patients require further investigation.

Methods: This retrospective, real-world study involved non-diabetic CKD patients from April 2023 to June 2024. Participants received finerenone alongside standard CKD treatment. Primary clinical results included changes in the urinary albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), and serum potassium (sK+) levels. The data were collected initially and during follow-ups at 1, 3, 6, and 12 months.

Results: In total, 37 non-diabetic CKD patients were included in the population; 21 individuals (56.8%) were male, and the mean age was 48.84 ± 14.69 years. During the follow-up, there was a notable decrease in UACR, with a median reduction of 664.95 mg/g (IQR, 196.60-1226.70, P = 0.002). The baseline average eGFR was 70.80 ± 27.97 mL/min/1.73m2, with no notable alterations observed during the follow-up (P > 0.05). In terms of safety analysis, the sK + levels were within the 3.5-5.5 mmol/L range, with no significant difference from the baseline (P > 0.05). No patients discontinued treatment or were hospitalized because of hyperkalemia.

Conclusion: Real-world practice indicates that finerenone is effective and safe for non-diabetic CKD patients, but further large-scale, prospective studies are needed to confirm these findings.

Keywords: Chronic kidney disease; Finerenone; Non-diabetic.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Ethics Committee of Zhongshan Hospital of Xiamen University (IRB approval No. 2025-026), with the requirement for informed consent waived in accordance with the retrospective observational study design. Ethics approval was applied in accordance with the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The effect of finerenone on the relative changes in urinary albumin-to-creatinine ratio (UCAR) from baseline to 12 months follow-up
Fig. 2
Fig. 2
The effect of finerenone on the relative changes in estimated glomerular filtration rate (eGFR) from baseline to 12 months follow-up
Fig. 3
Fig. 3
The effect of finerenone on the relative changes in serum potassium (sK+) from baseline to 12 months follow-up
See this image and copyright information in PMC

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