Can Finerenone Alter Glomerular Disease Trajectory?

A prespecified exploratory analysis of the FIND-CKD clinical trial examined kidney function, albuminuria, and kidney failure outcomes in 903 patients with glomerular diseases.

By
Kathryn Wighton
June 5, 2026
4 min

Conexiant

Overview

Finerenone demonstrated a slower decline in eGFR compared to placebo in patients with glomerular diseases. The treatment also significantly reduced urinary albumin-to-creatinine ratios in the immunoglobulin A nephropathy subgroup.

Background

Chronic kidney disease (CKD) is a major public health concern, particularly in patients with glomerular diseases. Effective management strategies are crucial to slow disease progression and improve patient outcomes. Finerenone, a nonsteroidal mineralocorticoid receptor antagonist, has shown promise in managing CKD, particularly in diabetic populations, but its effects in nondiabetic glomerular diseases require further exploration.

Data Highlights

Parameter	Finerenone	Placebo
eGFR slope (mL/min/1.73 m² per year)	-3.50	-4.23
Kidney failure or sustained eGFR decline (events per 100 patient-years)	7.42	9.60
Reduction in urinary albumin-to-creatinine ratio (12 months)	47%	N/A

Key Findings

Finerenone reduced the eGFR decline by 0.73 mL/min/1.73 m² per year compared to placebo.
In the immunoglobulin A nephropathy subgroup, finerenone reduced urinary albumin-to-creatinine ratio by 47%.
Serious adverse events occurred in 20% of participants receiving finerenone.
Finerenone was associated with a 1.22 mL/min/1.73 m² per year attenuation of chronic eGFR decline after 3 months.
Subgroup analyses showed a treatment effect of 1.34 mL/min/1.73 m² per year in focal segmental glomerulosclerosis.

Clinical Implications

The findings suggest that finerenone may be a beneficial treatment option for patients with glomerular diseases, particularly in slowing eGFR decline and reducing proteinuria. Clinicians should consider finerenone as part of a comprehensive management strategy for these patients, while monitoring for potential adverse effects.

Conclusion

Finerenone shows promise in altering the trajectory of glomerular disease by slowing eGFR decline and reducing proteinuria. Further studies are warranted to confirm these findings and explore its long-term benefits.