Finerenone arrests CKD progression by effecting early reduction of albuminuria in diabetes patients

A post-hoc mediation analysis of FIGARO-DKD and FIDELIO-DKD trials showed that early albuminuria reduction with finerenne accounted for the majority of the treatment effect against chronic kidney disease progression in type 2 diabetes patients. The reduction in urine albumin-to-creatinine ratio mediated 84% of the treatment effect on kidney outcomes and 37% of the effect on cardiovascular outcomes over 4 years. The findings support American Diabetes Association guidelines for lowering UACR and suggest that monitoring UACR levels for treatment benefits may be beneficial for clinicians caring for diabetes patients. Finerenone, approved by the FDA in 2021, is the first non-steroidal, selective mineralocorticoid receptor antagonist to slow CKD progression in T2D patients.

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