Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes

What is it about?

This study investigates the long-term effects of finerenone, a selective mineralocorticoid receptor antagonist, on patients with chronic kidney disease (CKD) and type 2 diabetes. The researchers conducted a double-blind trial involving 5734 such patients who were randomly assigned to receive finerenone or a placebo. To be eligible, patients had specific criteria related to urinary albumin-to-creatinine ratio, glomerular filtration rate, and diabetic retinopathy. The primary outcome was a composite of kidney failure, a significant decrease in glomerular filtration rate, or death from renal causes. The key secondary outcome included death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Over a median follow-up of 2.6 years, the study found that the primary outcome occurred less frequently in the finerenone group (17.8%) compared to the placebo group (21.1%). Similarly, the key secondary outcome was less frequent in the finerenone group (13.0%) compared to the placebo group (14.8%). The study also noted that adverse events were similar between the two groups, with hyperkalemia-related discontinuation being slightly higher with finerenone.

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Photo by Towfiqu barbhuiya on Unsplash

Photo by Towfiqu barbhuiya on Unsplash

Why is it important?

Chronic kidney disease (CKD) is a significant concern for individuals with type 2 diabetes, leading to kidney and cardiovascular complications. While current guidelines recommend specific treatments, there remains a need for therapies that can further reduce the risks associated with CKD in these patients. This study's significance lies in its investigation of finerenone, a nonsteroidal mineralocorticoid receptor antagonist, as a potential treatment option for CKD in individuals with type 2 diabetes. The trial demonstrates that finerenone can lower the risk of CKD progression and cardiovascular events in this high-risk population. The findings of this study highlight the importance of targeting the mineralocorticoid receptor in managing CKD and its associated complications. Unlike some previous therapies that increased the risk of adverse events, finerenone showed a favorable safety profile with only a slightly higher incidence of hyperkalemia-related discontinuation. Overall, this research provides hope for improving the long-term outcomes of individuals with CKD and type 2 diabetes, offering a potentially more effective treatment option. It emphasizes the importance of continuing to explore innovative therapies that can reduce the burden of CKD, particularly in populations at high risk for kidney and heart complications. Key takeaways: 1. Finerenone, a mineralocorticoid receptor antagonist, was studied as a treatment for chronic kidney disease (CKD) in type 2 diabetes patients. 2. The study found that finerenone reduced the risk of CKD progression and cardiovascular events compared to a placebo. 3. Adverse events were similar between the two groups, with slightly more hyperkalemia-related discontinuation in the finerenone group. 4. This research offers hope for improving long-term outcomes in CKD patients with type 2 diabetes.