New findings indicate that finerenone may help protect kidney function and reduce major health risks in people with chronic kidney disease who do not have diabetes.
Chronic kidney disease affects an estimated 800 million people worldwide and is one of the leading causes of kidney failure, cardiovascular complications, and premature death. Yet for many patients who do not have diabetes, treatment options remain limited.
Now, researchers report that finerenone, a drug previously shown to benefit people with diabetic kidney disease, can also slow kidney function decline in patients without diabetes. The findings, published in the New England Journal of Medicine, could expand the use of the medication to a much larger population of CKD patients.
The results come from the international FIND-CKD trial, led by clinical pharmacologist Hiddo Lambers Heerspink of the University Medical Center Groningen.
Slowing a Disease That Often Progresses Silently
Chronic kidney disease is frequently called a “silent” disease because symptoms may not appear until significant damage has already occurred. As kidney function worsens, patients face an increased risk of kidney failure, heart disease, hospitalization, and death.
To evaluate whether finerenone could slow that progression, researchers enrolled 1,584 adults with chronic kidney disease who did not have diabetes. All participants had reduced kidney function and elevated protein levels in their urine, both indicators of ongoing kidney damage.
Participants received either finerenone or a placebo in addition to standard therapy with ACE inhibitors or angiotensin receptor blockers, medications commonly used to protect kidney function and control blood pressure. Researchers followed the patients for an average of just over three years.
Finerenone Slows Kidney Function Decline
Researchers evaluated changes in kidney function over a 2.5-year period using estimated glomerular filtration rate (eGFR), a measure of how effectively the kidneys filter blood.
Patients treated with finerenone experienced a significantly slower decline in eGFR than those who received a placebo. According to Lambers Heerspink, the improvement was both statistically significant and clinically meaningful.
The treatment also lowered the risk of major kidney complications, hospitalization for heart failure, and death from cardiovascular disease. Lambers Heerspink said, “In the finerenone group, 13.9 percent experienced such a complication, compared to 16.9 percent in the placebo group. That amounts to a reduction in risk of approximately 23 percent.”
Protein Levels in Urine Improved
Finerenone users also saw notable reductions in urinary protein levels after six months of treatment.
Lambers Heerspink said, “The presence of protein in the urine is often an important and early sign of kidney damage. In the finerenone group, it decreased by an average of over 41 percent, compared to about 9 percent in the placebo group. More than half of the patients who received finerenone achieved a reduction of at least 30 percent in the amount of protein in their urine. Such a reduction is an important indicator of a more favorable renal prognosis.”
The results are particularly noteworthy because earlier large-scale studies of finerenone focused mainly on people with type 2 diabetes. Lambers Heerspink said, “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. Chronic kidney disease now affects an estimated 800 million adults worldwide.”
The study also found that finerenone was safe for use in this patient population.
Lambers Heerspink said, “Finerenone could become an important new treatment option for people with chronic kidney disease who do not have diabetes. The drug offers a clear delay in the decline of kidney function on top of current standard care. The results provide physicians with new therapeutic options to help preserve kidney function and reduce the number of cardiovascular and renal complications. And this applies to a broad, underserved patient population with non-diabetic CKD, for whom there are few treatment options in the guidelines.”
Reference: “Finerenone in Persons with Chronic Kidney Disease without Diabetes” by Hiddo J.L. Heerspink, Brendon L. Neuen, Rajiv Agarwal, David Z.I. Cherney, Carolyn S.P. Lam, Katherine R. Tuttle, Christoph Wanner, Pantelis Sarafidis, Niels Jongs, J. David Smeijer, Meike Brinker, Nicole Rethemeier, Patrick Schloemer, Paula Vesterinen, David Goldsbury, Sara Dizayee, Jon W. Mares and Vlado Perkovic, 3 June 2026, New England Journal of Medicine.
DOI: 10.1056/NEJMoa2604625
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