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Research Article: Efficacy and safety of finerenone in chronic kidney disease stages 3–4 in diabetic and non-diabetic patients with an eGFR 20–60 mL/min: a prospective cohort study

Date Published: 2026-05-08

Abstract:
Finerenone, when added to the standard-of-care treatment for chronic kidney disease (CKD), can effectively slow its progression. While previous trials have primarily focused on patients with diabetic kidney disease and an estimated glomerular filtration rate (eGFR) above 25 ml/min, this study aimed to evaluate the efficacy and safety of finerenone in patients with CKD stage 3–4, encompassing both diabetic and non-diabetic patients with an eGFR ranging from 20 to 60 ml/min. This prospective cohort study included 180 patients with CKD stage 3–4, including diabetic and non-diabetic participants. These patients had an eGFR of 20–60 ml/min and an urinary albumin-to-creatinine ratio (UACR) higher than 30 mg/g. The study was conducted between January 2023 and June 2024 at the Basra Nephrology and Transplantation Center and Private Clinic. Finerenone showed statistically significant improvements in eGFR and UACR over a one-year period among all patient groups, including the subgroup of non-diabetic patients and patients with an eGFR between 20 and 25 ml/min (P < 0.001). Importantly, finerenone did not elevate serum potassium levels. The study population had a mean age of 61.67 ± 13.37 years, 50.6% aweremen,78% awerewdiabetic,22% awerewnon-diabeticand 65 (36%) hhadFR of 20–25 ml/min. Finerenone is a safe and effective approach for slowing the progression of CKD in patients with an eGFR > 20 ml/min and moderately to severely increased albuminuria, regardless of diabetes status.

Introduction:
Finerenone, when added to the standard-of-care treatment for chronic kidney disease (CKD), can effectively slow its progression. While previous trials have primarily focused on patients with diabetic kidney disease and an estimated glomerular filtration rate (eGFR) above 25 ml/min, this study aimed to evaluate the efficacy and safety of finerenone in patients with CKD stage 3–4, encompassing both diabetic and non-diabetic patients with an eGFR ranging from 20 to 60 ml/min.

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