Finerenone as adjunctive therapy for residual proteinuria in lupus nephritis: a case series of 10 patients
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By
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Rui Gao
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Jianan Wang
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Qi Liu
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Ming Li
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July 3, 2026
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Clinical Scorecard: Finerenone as a supplementary treatment for persistent proteinuria in lupus nephritis: a case series involving 10 patients
At a Glance
| Category | Detail |
|---|
| Condition | Lupus Nephritis |
| Key Mechanisms | Mineralocorticoid receptor overactivation contributes to renal injury and proteinuria persistence. |
| Target Population | Patients with lupus nephritis and residual proteinuria despite standard treatment. |
| Care Setting | Single-center retrospective case series. |
Key Highlights
- Finerenone 10 mg daily significantly reduced 24-h urine protein from 1.595 g to 0.315 g over 24 weeks.
- Serum albumin increased from 3.68 g/dL to 4.075 g/dL.
- Estimated glomerular filtration rate (eGFR) remained stable throughout the study.
- All patients completed the 24-week follow-up with favorable safety profile.
- Study addresses gaps in understanding finerenone's efficacy and safety in lupus nephritis.
Guideline-Based Recommendations
Diagnosis
- Clinical diagnosis of lupus nephritis established per 2019 ACR criteria.
Management
- Add-on finerenone 10 mg daily for patients with residual proteinuria.
Monitoring & Follow-up
- Monitor serum potassium and eGFR during treatment.
Risks
- Potential for hyperkalemia and renal function decline in patients with impaired renal function.
Patient & Prescribing Data
10 patients with lupus nephritis and persistent proteinuria.
Finerenone was well-tolerated and effective in reducing proteinuria.
Clinical Best Practices
- Ensure stable renal function (eGFR ≥ 60 mL/min/1.73 m2) before initiating finerenone.
- Monitor for electrolyte imbalances, particularly potassium levels.
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