What question did this study set out to answer?

To evaluate the real-world effectiveness of finerenone in reducing albuminuria in diabetic chronic kidney disease (CKD) patients.

June 7, 2026

1385-P: Real-World Reduction in Albuminuria with Finerenone in Patients with Diabetic Chronic Kidney Disease

Key Points

To evaluate the real-world effectiveness of finerenone in reducing albuminuria in diabetic chronic kidney disease (CKD) patients.
Retrospective analysis of 83 patients with diabetic CKD treated with finerenone
Assessment of urinary albumin-to-creatinine ratio at baseline and follow-up
Statistical analysis performed using GraphPad 10.6.1
Mean urinary albumin-to-creatinine ratio (UACR) decreased from 274.6 mg/g to 144.8 mg/g (p = 0.0033)
A ≥30% reduction in UACR was achieved in approximately 78% of patients
Concomitant SGLT2 inhibitor use was associated with greater UACR reductions compared to those not on SGLT2 inhibitors

Abstract

Introduction and Objective: Albuminuria is a validated surrogate of cardiorenal risk in diabetic CKD. Finerenone reduced albuminuria in FIDELIO-DKD and FIGARO-DKD, but real-world data remain limited. Methods: This retrospective analysis included 83 patients with diabetic CKD treated with finerenone. Mean age was 63 years (95% CI: 61-65) and mean diabetes duration was 17 years (95% CI: 15-19). Urinary albumin-to-creatinine ratio (UACR) was assessed at baseline and follow-up, at and categorized as normal (30 mg/g), microalbuminuria (30-300 mg/g), or macroalbuminuria (300 mg/g). A ≥30% reduction in UACR was predefined as a clinically meaningful response. GraphPad 10.6.1 was used for statistical analysis Results: Mean UACR decreased significantly from 274.6 mg/g to 144.8 mg/g, with absolute reduction of 129.9 mg/g and a mean relative reduction of 44.6% (p = 0.0033; Cohen’s d = 0.46). Median UACR declined from 154.2 to 55.2 mg/g, with consistent reductions across interquartile ranges, indicating a broad distributional shift. Overall, 38 patients (45.8%) improved their albuminuria category, 44 (53.0%) remained stable, and one patient worsened. A ≥30% reduction in UACR was achieved in approximately 78% of patients. Concomitant SGLT2 inhibitor use was associated with numerically greater UACR reductions. Glycemic control remained stable, with no significant change in HbA1c (8.52% to 8.17%; p = 0.1185) Conclusion: In patients with T2DM and CKD, finerenone led to clinically meaningful reduction in albuminuria, with high responder rates and minimal progression. Patients receiving concomitant SGLT2 inhibitors with finerenone demonstrated numerically greater reductions in UACR compared with those not on SGLT2 inhibitors. The magnitude and pattern of UACR reduction are directionally consistent with FIDELIO-DKD and FIGARO-DKD trials, supporting the real-world translational relevance of finerenone-mediated renal risk modification independent of glycemic effects. Disclosure D.A. Padhye: None. S. Patange: None.

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