Early Efficacy and Safety of Finerenone on Type 2 Diabetes-Related Chronic Kidney Disease: A Real-World Observational Study in China

IF 6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes/Metabolism Research and Reviews Pub Date : 2025-08-21 DOI:10.1002/dmrr.70078

Liyu Lin, Ziyan Shen, Zhihong Chen, Yang Li, Yiqi Su, Jie Teng, Xiaoqiang Ding, Jiaming Zhu

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Abstract

Aims

This observational study aimed to assess the early efficacy and safety of finerenone in patients with type 2 diabetes-related chronic kidney disease (CKD) in China with or without sodium-glucose cotransporter-2 inhibitors (SGLT-2i) or renin-angiotensin system inhibitors (RASi).

Materials and Methods

Patients with type 2 diabetes-related CKD who initiated finerenone therapy between March 2023 and February 2024 at Zhongshan Hospital, Fudan University were retrospectively included. All patients were followed up at least once during the 12-week observation period. Key parameters, including urinary albumin/creatinine ratio (UACR), 24-h urine protein, serum creatinine, and potassium (K⁺) levels, were recorded. Estimated glomerular filtration rate (eGFR) was calculated based on serum creatinine using the Collaborative Epidemiological Formula for Chronic Kidney Disease.

Results

A total of 105 patients (mean age, 59.4 ± 13.3 years; 81 males and 24 females) were included, with 82.9% diagnosed with diabetic nephropathy. After 12 weeks of finerenone treatment, UACR declined by 39.55%, with consistent results across all treatment groups, regardless of baseline eGFR or concomitant SGLT-2i/RASi use. A decline in eGFR > 30% occurred in 6.67% of patients, while a > 10% decline occurred in 61.9%. Hyperkalemia (serum K⁺ > 5.5 mmol/L) was observed in 8.57% of patients, mainly in those with eGFR < 60 mL/min/1.73 m², with the highest incidence (37.5%) in those with eGFR < 30 mL/min/1.73 m².

Conclusions

Finerenone effectively reduced albuminuria in patients with type 2 diabetes-related CKD; however, close monitoring of eGFR and serum K⁺ levels is essential, particularly in those with reduced baseline renal function.

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菲尼酮治疗2型糖尿病相关慢性肾脏疾病的早期疗效和安全性：一项在中国的真实世界观察性研究

本观察性研究旨在评估芬尼酮在中国2型糖尿病相关慢性肾病（CKD）患者中使用或不使用钠-葡萄糖共转运蛋白-2抑制剂（SGLT-2i）或肾素-血管紧张素系统抑制剂（RASi）的早期疗效和安全性。材料与方法回顾性分析2023年3月至2024年2月在复旦大学中山医院接受芬烯酮治疗的2型糖尿病相关CKD患者。在12周的观察期内，所有患者至少随访1次。记录尿白蛋白/肌酐比值（UACR）、24小时尿蛋白、血清肌酐、钾（K+）水平等关键参数。估计肾小球滤过率（eGFR）是基于血清肌酐使用协作流行病学公式慢性肾脏疾病计算。结果共纳入105例患者（平均年龄59.4±13.3岁，男81例，女24例），诊断为糖尿病肾病的患者占82.9%。在芬尼酮治疗12周后，UACR下降了39.55%，所有治疗组的结果一致，无论基线eGFR或同时使用SGLT-2i/RASi。6.67%的患者eGFR下降30%，61.9%的患者eGFR下降10%。8.57%的患者出现高钾血症（血清K+ >； 5.5 mmol/L），以eGFR <为60 mL/min/1.73 m2者为主，eGFR <为30 mL/min/1.73 m2者发生率最高（37.5%）。结论芬纳酮可有效降低2型糖尿病相关性CKD患者蛋白尿；然而，密切监测eGFR和血清K+水平是必要的，特别是那些基线肾功能降低的患者。

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来源期刊

Diabetes/Metabolism Research and Reviews 医学-内分泌学与代谢

CiteScore

17.20

自引率

2.50%

发文量

审稿时长

4-8 weeks

期刊介绍： Diabetes/Metabolism Research and Reviews is a premier endocrinology and metabolism journal esteemed by clinicians and researchers alike. Encompassing a wide spectrum of topics including diabetes, endocrinology, metabolism, and obesity, the journal eagerly accepts submissions ranging from clinical studies to basic and translational research, as well as reviews exploring historical progress, controversial issues, and prominent opinions in the field. Join us in advancing knowledge and understanding in the realm of diabetes and metabolism.