A landmark clinical trial has demonstrated that finerenone can substantially slow kidney function deterioration in patients with chronic kidney disease who do not have diabetes, opening a treatment path for a population that has historically lacked effective options beyond standard care.
The FIND-CKD study, published in the New England Journal of Medicine, tracked 1,584 adults over roughly three years. All participants had impaired kidney function and elevated urinary protein, a marker of progressive kidney damage. Half received daily finerenone while continuing standard medications, and half received placebo alongside the same baseline treatment.
Researchers measured kidney performance using estimated glomerular filtration rate, which gauges how efficiently the kidneys filter waste. The finerenone group showed a statistically and clinically meaningful slowdown in eGFR decline compared to the placebo group, according to lead researcher Hiddo Lambers Heerspink of the University Medical Center Groningen.
Beyond preserving kidney function, the drug delivered broader health gains. Finerenone reduced the risk of major kidney events, hospitalization for heart failure, and cardiovascular death by approximately 23 percent. In the treatment group, 13.9 percent experienced such complications versus 16.9 percent in the placebo arm.
Protein in urine, an early warning sign of kidney damage, fell by more than 41 percent in patients taking finerenone, compared to about 9 percent in those given placebo. More than half of treated patients achieved at least a 30 percent reduction in urinary protein, which researchers say points to a more favorable long-term kidney prognosis.
The findings carry particular weight because prior finerenone trials concentrated almost exclusively on diabetic patients. Non-diabetic chronic kidney disease affects more than half of all CKD patients globally, a group largely without guideline-approved therapies. The global CKD burden now touches approximately 800 million adults.
Lambers Heerspink noted that finerenone proved safe throughout the study period and represents a meaningful addition to current treatment protocols. The drug works on top of ACE inhibitors and angiotensin receptor blockers, the standard medications most patients already take.
Author Jessica Williams: "This trial answers a crucial question: finerenone works where it matters most, for patients who have been trapped with limited options and declining kidney function."
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