To evaluate the effects of add-on finerenone on residual proteinuria in patients with lupus nephritis (LN) after standard treatment.
Approach:
Study Design: A single-center retrospective case series involving 10 patients with clinically diagnosed LN and residual proteinuria despite ≥6 months of standard treatment.
Intervention: Finerenone 10 mg once daily was added to the original treatment for 24 weeks.
Endpoints: Primary endpoint was change in 24-h urine protein quantification; secondary endpoints included serum albumin, estimated glomerular filtration rate (eGFR), and safety parameters.
Key Findings:
Significant reduction in 24-h urine protein from 1.595 g at baseline to 0.315 g at 24 weeks (p < 0.001).
Increase in serum albumin from 3.68 g/dL to 4.075 g/dL.
eGFR remained stable throughout the follow-up period.
Interpretation:
Add-on low-dose finerenone was associated with a significant reduction in residual proteinuria and an increase in serum albumin, with stable renal function and a favorable safety profile.
Limitations:
Small sample size of 10 patients.
Retrospective design limits generalizability.
Lack of unified renal biopsy data for all participants.
Conclusion:
These observational findings require validation in controlled trials.
