Chronic kidney disease is a long-lasting condition in which the kidneys gradually stop working as well as they should.
In the early stages, many people have few symptoms, but the disease can slowly lead to kidney failure and increase the risk of heart problems. Finding treatments that slow this process is one of the biggest goals in kidney medicine.
A major international study now offers encouraging news. Researchers found that finerenone, a medicine already used for some people with diabetic kidney disease, can also benefit patients who have chronic kidney disease without diabetes. The findings were published in the New England Journal of Medicine.
The study, called FIND-CKD, was led by Professor Hiddo Lambers Heerspink from the University Medical Center Groningen. It involved 1,584 adults from several countries who all had reduced kidney function and excess protein in their urine.
Protein in the urine is one of the earliest signs that the kidneys are damaged. Higher levels often mean the disease is more likely to get worse over time. Reducing protein in the urine is therefore an important treatment goal.
Participants received either finerenone or a placebo while continuing their usual kidney-protecting medicines. The researchers then followed them for a little more than three years to compare changes in kidney health.
The team measured kidney function using estimated glomerular filtration rate, or eGFR. People taking finerenone experienced a slower decline in eGFR, meaning their kidneys continued working better for longer than those in the placebo group.
The drug also lowered the chance of serious kidney and heart complications. Around 13.9% of people receiving finerenone experienced major kidney events, heart failure hospitalization, or cardiovascular death, compared with 16.9% of those taking the placebo.
Another major benefit was the reduction in protein levels in the urine. Finerenone reduced urinary protein by more than 41% on average, while the placebo group showed only about a 9% reduction. More than half of the treated patients achieved reductions of at least 30%, which is linked to a better outlook for kidney disease.
Until now, most large finerenone studies focused on people with type 2 diabetes. This research shows that the medicine may help a much larger group because more than half of all people with chronic kidney disease do not have diabetes.
The study also found no unexpected safety concerns during treatment. Even so, patients should only use finerenone under medical supervision because kidney function and blood potassium levels need monitoring.
Overall, this high-quality clinical trial provides strong evidence that finerenone could become an important addition to standard treatment for non-diabetic chronic kidney disease, although future guideline updates and real-world experience will help determine exactly which patients benefit the most.
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