Efficacy and safety of Finerenone in patients with chronic kidney disease associated with type 2 diabetes. Latin American Experience: Findkdlatam Trial

Patients with type 2 diabetes (DM2) and chronic kidney disease (CKD) face high renal and cardiovascular risks. Finerenone, a selective non-steroidal mineralocorticoid receptor antagonist (nsMRA), has demonstrated efficacy in reducing these risks in clinical trials. However, its real-world safety and effectiveness remain underexplored in local settings. We conducted an observational study in 347 patients with DM2 and CKD (urinary albumin-creatinine ratio [UACR] > 30 mg/g) across seven Latin American countries. Patients received Finerenone (10 or 20 mg daily), and clinical and laboratory parameters were evaluated at baseline and six months. At baseline, medians (IQR) were: HbA1c, 7.6% (6.8–8.1); eGFR, 39.0 (30.0–50.0) ml/min/1.73 m²; UACR, 345 (189–760) mg/g; SBP, 143 (130–160) mmHg; DBP, 79 (70–82) mmHg; serum potassium, 4.4 (4.1–4.7) mmol/L. After six months, significant reductions were observed: HbA1c, 7.0%; UACR, 81 mg/g; SBP, 130 mmHg; DBP, 73 mmHg. Serum potassium increased to 4.7 mmol/L (IQR 4.3–5.0), while eGFR remained stable (41.6 ml/min/1.73 m²; IQR 27.0–52.0). In our cohort of patients with chronic kidney disease associated with DM2, Finerenone proved to be an effective short-term medicine in reducing albuminuria, with very good tolerance and low risk of hyperkalemia.