Efficacy and safety of finerenone in non-diabetic CKD patients: a single-center, real-world, retrospective study

Background Finerenone, a novel non-steroidal mineralocorticoid receptor antagonist, has shown promising efficacy and safety profiles in the management of chronic kidney disease (CKD) associated with type 2 diabetes mellitus (T2DM). However, the effectiveness and safety of finerenone on non-diabetic CKD patients require further investigation. Methods This retrospective, real-world study involved non-diabetic CKD patients from April 2023 to June 2024. Participants received finerenone alongside standard CKD treatment. Primary clinical results included changes in the urinary albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), and serum potassium (sK ⁺ ) levels. The data were collected initially and during follow-ups at 1, 3, 6, and 12 months. Results In total, 37 non-diabetic CKD patients were included in the population; 21 individuals (56.8%) were male, and the mean age was 48.84 ± 14.69 years. During the follow-up, there was a notable decrease in UACR, with a median reduction of 664.95 mg/g (IQR, 196.60-1226.70, P  = 0.002). The baseline average eGFR was 70.80 ± 27.97 mL/min/1.73m ² , with no notable alterations observed during the follow-up ( P  > 0.05). In terms of safety analysis, the sK + levels were within the 3.5–5.5 mmol/L range, with no significant difference from the baseline ( P  > 0.05). No patients discontinued treatment or were hospitalized because of hyperkalemia. Conclusion Real-world practice indicates that finerenone is effective and safe for non-diabetic CKD patients, but further large-scale, prospective studies are needed to confirm these findings.