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August 31, 2026ZooKeysOpen Access

Finerenone is linked to a ~54% UACR reduction over 6 months in diabetic kidney disease.

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Why the study?

Does finerenone 10 mg once daily reduce UACR in adults with diabetic kidney disease?

Population

16 adults with a documented clinical diagnosis of diabetic kidney disease, mean age 68.4, 75.0% female…

Design

Cohort

Follow-up

6 months

Key result

Finerenone initiation was associated with a 54.1% median relative reduction in urine albumin-to-creatinine ratio over 6 months in patients with diabetic kidney disease.

Authors

RSRumina ShalevaSDStefani DanailovaМБМирослава Бенкова-Петрова

Discussion

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Overview

May reduce residual albuminuria on background therapy; hypothesis-generating in small observational cohort, needs RCTs.

Key Points

  • To evaluate longitudinal changes in urine albumin-to-creatinine ratio and safety markers following finerenone initiation in patients with diabetic kidney disease.
  • Retrospective observational study of 16 adults with diabetic kidney disease initiating finerenone 10 mg once daily at a single nephrology center.
  • Assessed changes in urine albumin-to-creatinine ratio (primary outcome), estimated glomerular filtration rate, and serum potassium at baseline, 3 months, and 6 months.
  • Median urine albumin-to-creatinine ratio decreased from 57.0 mg/g at baseline to 30.0 mg/g at 3 months and 18.0 mg/g at 6 months (54.1% median relative reduction; Friedman p < 0.001).
  • At 6 months, 80.0% (12/15) of patients achieved a ≥30% reduction and 60.0% (9/15) achieved a ≥50% reduction in urine albumin-to-creatinine ratio.
  • No statistically significant longitudinal changes occurred in estimated glomerular filtration rate (p = 0.112) or serum potassium (p = 0.166), with two patients reaching potassium ≥5.5 mmol/L.

Study Design

Type

Observational (n=16)

Multicenter

No

Structured PICO

Does finerenone 10 mg once daily reduce UACR in adults with diabetic kidney disease?

P
Population
16 adults with diabetic kidney disease who initiated finerenone 10 mg once daily, followed for 6 months.
E
Exposure
Finerenone 10 mg once daily
O
Outcome
Within-patient change in urine albumin-to-creatinine ratio (UACR) over 6 monthssurrogate

Main Result

p-value: p=<0.001

In a small real-world cohort of patients with diabetic kidney disease on background ACEi/ARB and SGLT2i therapy, finerenone initiation was associated with a significant reduction in albuminuria over 6 months without significant changes in eGFR or severe hyperkalemia.

Limitations

  • Retrospective design
  • Limited sample size
  • Absence of a comparator
  • Short follow-up
  • Potential confounding by concomitant therapies
  • UACR obtained from routine spot samples without standardized repeated confirmation
  • retrospective design
  • limited sample size
  • absence of a comparator
  • short follow-up
  • potential confounding by concomitant therapies

Cite This Study

Shaleva et al. (2026) conducted an observational in Diabetic kidney disease (n=16). Finerenone was evaluated on Change in urine albumin-to-creatinine ratio (UACR) over 6 months (p=<0.001). Finerenone initiation was associated with a 54.1% median relative reduction in urine albumin-to-creatinine ratio over 6 months in patients with diabetic kidney disease.

synapsesocial.com/papers/6a954223f20e493292a74283https://doi.org/10.3897/pharmacia.73.e189397
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Real-World Impact of Finerenone on Albuminuria in Patients with Diabetes and CKD2025
  2. 2Early Efficacy and Safety of Finerenone on Type 2 Diabetes‐Related Chronic Kidney Disease: A Real‐World Observational Study in China2025
  3. 3Evaluating the Efficacy of Finerenone in Reducing Proteinuria in Diabetic Nephropathy Patients Receiving Maximum Tolerable Doses of Dapagliflozin and Telmisartan2025
  4. 4Effect of finerenone on urinary protein and inflammatory factor levels in type 2 diabetes mellitus patients with diabetic kidney disease2025
  5. 5Real-world outcomes of Finerenone in patients with diabetic kidney disease in Saudi Arabia2026