Finerenone slows eGFR decline in patients with CKD due to glomerular disease

Compared with placebo, finerenone slowed the decline in estimated glomerular filtration rate (eGFR) in patients with non-diabetic chronic kidney disease (CKD) due to glomerular disease.

Prof. Brendon Neuen (The George Institute for Global Health, Australia) presented a prespecified subgroup analysis of the phase 3 FIND-CKD trial (NCT05047263) in patients with CKD due to glomerular disease [1]. Of the overall FIND-CKD population, 57.0% had glomerular disease as the underlying cause of CKD, including 26.3% with immunoglobulin A (IgA) nephropathy, 13.6% with focal segmental glomerulosclerosis, 5.7% with membranous nephropathy, 1.6% with membranoproliferative glomerulonephritis, and 9.8% with other causes.

The eGFR curves in patients with glomerular disease showed a trend similar to that observed in the overall FIND-CKD population. In the placebo group, eGFR declined linearly, reaching an annualised decline of 4.2 mL/min/1.73 m²/year by month 36. In the finerenone group, eGFR showed an initial steep decline before stabilising, resulting in an annualised decline of 3.5 mL/min/1.73 m²/year by month 36, corresponding to a between-group difference of 0.7 mL/min/1.73 m²/year (95% CI 0.2–1.2). Furthermore, urinary albumin-to-creatinine ratio (UACR) decreased by 42% from baseline with finerenone, whereas it remained stable with placebo (0% change) at month 12, corresponding to a between-group difference of -42% (95% CI -48% to -35%). Regarding safety, finerenone demonstrated a profile in patients with glomerular diseases that was consistent with that observed in the overall FIND-CKD population.

“In this prespecified subgroup analysis from the FIND-CKD trial, finerenone compared with placebo slowed the annualised rate of eGFR decline and reduced albuminuria,” concluded Prof Neuen. “Finerenone was overall well-tolerated, with a safety profile consistent with that of the overall FIND-CKD population.”

Neuen B, et al. Finerenone in patients with glomerulonephritis. ERA 2026, 3–6 June. Glasgow, Scotland.