Endocrine Abstracts

Background: Chronic kidney disease develops in approximately 40% of patients with type 2 diabetes mellitus (T2DM) and significantly increases the risk of mortality and cardiovascular morbidity. Finerenone, a novel nonsteroidal mineralocorticoid receptor antagonist, has demonstrated a significant impact on renal function by reducing proteinuria and preserving glomerular filtration rate in patients with chronic kidney disease. However, the influence of finerenone on kidney function in the different patients populations requires the further investigation. Therefore, the aim of our study was to investigate the influence of treatment with finerenone on kidney function in patients with chronic kidney disease with and without T2DM.

Methods: Two groups of patients were examined. The first group included 45 patients with T2DM who were taking finerenone. Their age was 63.0±6.0 years, duration of diabetes - 7.0±4.0 years, HbA1c was 7.6±2.2%, creatinine level –115.6±3.78 µ mol/l, estimated glomerular filtration rate (eGFR) –50.95±1.56 ml/min/1.73m², and the urinary albumin-to-creatinine ratio (UACR) –43.08±10.84 mg/g % (data are presented as mean±SD). The second group consisted of 40 patients without type 2 diabetes but with chronic kidney disease (CKD) who were taking finerenone. Their age was 54,0±4,0 years, HbA1c –5.1±0.9%, creatinine level –84.73±2.01 µ mol/l, eGFR –83.60±1.86 ml/min/1.73 m², and UACR –25.14±4.18 mg/g. To compare the effect of finerenone on eGFR and UACR, we used one-way analysis of variance (ANOVA) and Student’s t-test.

Results: In patients with diabetes, the increase in eGFR under the influence of the drug does not significantly differ between groups with and without diabetes (54.41±1.77 ml/min/1.73 m²; 86.75±1.69 ml/min/1.73 m², –respectively, P<0.05). The decrease in UACR under the influence of the drug does not significantly differ between groups with and without diabetes, but there is a tendency toward a more pronounced effect in patients without diabetes (42.42±10.68 mg/g; 21.32±4.38 mg/g,–respectively, P<0.05).

Conclusion: We found that finerenone positively affects kidney function in patients with and without T2M. The administration of finerenone has been associated with a decrease in urinary albumin excretion and a slowing of the progression of kidney disease, highlighting its potential as a therapeutic option for managing renal complications.