Chronic kidney disease is one of the world’s fastest-growing health problems, affecting an estimated 850 million people globally.
Many people do not realize they have the condition until significant damage has already occurred because kidney disease often develops slowly and quietly over many years.
As kidney function declines, waste products and excess fluid can build up in the body, increasing the risk of heart disease, hospitalization, disability, and premature death.
Scientists have therefore been searching for treatments that can slow kidney damage and help patients live longer.
Now, a series of major international studies suggests that a drug called finerenone may help a much larger group of patients than doctors previously believed.
The findings were presented at the European Renal Association Congress in Glasgow and published at the same time in three leading medical journals: The Lancet, The New England Journal of Medicine, and JAMA.
Having related studies published simultaneously in three of the world’s most respected medical journals is highly unusual and highlights the importance of the research.
Finerenone is already approved in many countries for people who have chronic kidney disease linked to type 2 diabetes. The drug works by blocking a protein called the mineralocorticoid receptor.
When this receptor becomes overactive, it can trigger inflammation and scarring inside the kidneys. Over time, this damage reduces the kidneys’ ability to filter blood properly.
Researchers wanted to know whether finerenone could also help people with chronic kidney disease who do not have diabetes. To answer this question, they carried out the FIND-CKD trial involving 1,584 patients from 24 countries.
The study found that adding finerenone to standard treatment significantly slowed the loss of kidney function. Patients taking the drug were 23% less likely to experience kidney failure, worsening kidney disease, heart failure, or death from cardiovascular causes compared with those receiving placebo treatment.
The researchers then examined a specific group of patients with glomerular diseases. These conditions occur when the kidney’s filtering units become damaged, often because of abnormal immune system activity. Treatment options for these patients are limited, making the findings especially important.
In this group, finerenone reduced the risk of kidney failure or disease progression by 26%. It also reduced protein in the urine by 42% after one year. Protein in the urine is a major warning sign that kidney damage is worsening.
In a third analysis, scientists combined data from several large studies involving 14,574 patients with both diabetic and non-diabetic chronic kidney disease.
The results showed that finerenone reduced the risk of kidney failure or worsening kidney disease by 24%. It also lowered the risk of hospitalization for heart failure or death from cardiovascular disease by 20%. Overall deaths from any cause were reduced by 12%.
One particularly encouraging finding was that the benefits appeared consistent across many different patient groups. The positive effects did not depend on whether patients had diabetes, the type of kidney disease they had, or how much kidney function remained at the start of the study.
The drug was generally well tolerated. Higher potassium levels occurred more often among patients taking finerenone, but serious problems were uncommon. Few patients needed to stop treatment because of this side effect, and hospitalizations related to high potassium levels were rare.
These findings are important because chronic kidney disease is becoming a major public health challenge. Experts predict that it could become one of the leading causes of premature death worldwide by 2040. Current treatment options remain limited for many patients, particularly those without diabetes.
The studies suggest that finerenone could eventually become a standard treatment for a much broader range of chronic kidney disease patients.
The large number of participants, international design, and consistent results across several studies strengthen confidence in the findings. However, doctors will still need to carefully monitor potassium levels in patients receiving the drug.
Overall, the research provides strong evidence that finerenone may help slow kidney damage, reduce heart-related complications, and improve survival for millions of people living with chronic kidney disease.
If treatment guidelines are updated in the future, many patients who currently have limited options could gain access to a therapy that helps protect both their kidneys and their hearts.
Study analysis: The biggest strength of this research is that it combines evidence from multiple large clinical trials involving patients from many countries. The benefits were consistent across different forms of kidney disease, making the findings highly convincing.
A limitation is that long-term outcomes beyond the study periods still need further investigation. Nevertheless, the results strongly support expanding the role of finerenone in chronic kidney disease treatment and may represent one of the most important advances in kidney medicine in recent years.
If you care about kidney health, please read studies about drug that prevents kidney failure in diabetes, and drinking coffee could help reduce risk of kidney injury.
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