- Question
- Does finerenone, a nonsteroidal mineralocorticoid receptor antagonist, slow the progression of chronic kidney disease in people without diabetes?
- Design
- Phase 3, randomized, double-blind, placebo-controlled, multicenter trial in which 1584 adults were assigned to finerenone or placebo; the primary outcome was assessed over 32 months.
- Population
- Adults without diabetes who had chronic kidney disease (eGFR 25 to <90 ml/min/1.73 m2) and albuminuria (urinary albumin-to-creatinine ratio 200 to ≤3500), and were receiving a renin-angiotensin system inhibitor.
- Intervention
- Finerenone 10 or 20 mg daily, on top of standard of care.
- Control
- Placebo, on top of standard of care.
- Primary outcome
- Total eGFR slope, defined as the mean annual rate of change in eGFR from baseline to month 32, estimated with a two-slope linear spline mixed-effects model.
- Results
- The annual rate of change in eGFR was -3.3 ml/min/1.73 m2 with finerenone and -4.0 with placebo (difference 0.7; 95% CI 0.3 to 1.1; P<0.001). The composite of kidney or cardiovascular events was lower with finerenone (HR 0.77; 95% CI 0.60 to 0.99; P = 0.04).
- Safety
- The most common adverse event was hyperkalemia: 135 participants (17.0%) with finerenone and 105 (13.3%) with placebo; it led to discontinuation of the trial regimen in 12 (1.5%) and 1 (0.1%), respectively.
- Conclusion
- In adults with chronic kidney disease without diabetes, finerenone led to a slower decline in eGFR than placebo over 32 months.
- Why it matters
- It extends the benefit of finerenone, previously shown only in patients with type 2 diabetes, to patients with non-diabetic chronic kidney disease and albuminuria, offering a new option to slow kidney progression.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 14, 2026