Key result
Finerenone significantly reduced proteinuria by 40% at six months compared to baseline in kidney transplant recipients, although this decrease was not statistically significantly different from the control group.
Why the study?
Finerenone has emerged as a promising nonsteroidal mineralocorticoid receptor antagonist for CKD, but its safety and efficacy in kidney transplant recipients remain unstudied.
Does finerenone reduce proteinuria without impairing renal function in kidney transplant patients?
Cohort (n=30)
Yes
Does finerenone reduce proteinuria without impairing renal function in kidney transplant patients?
Finerenone appears to be a promising and effective adjunctive therapy for reducing proteinuria in kidney transplant recipients, though early and close monitoring is required due to the risk of hyperkalemia.
May support adjunctive proteinuria management in kidney transplant recipients with potassium monitoring; extends CKD data but leaves open randomized efficacy.
Background: Finerenone has emerged as a promising nonsteroidal mineralocorticoid receptor antagonist for patients with chronic kidney disease (CKD), yet its safety and efficacy in kidney transplant recipients remain unstudied. Methods: A total of 1750 kidney transplant recipients were screened, and 39 were prescribed finerenone alongside angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. Fifteen patients who met inclusion criteria and used finerenone consistently for at least six months were compared with 15 matched controls. Proteinuria, renal function, serum potassium, and other laboratory and clinical parameters were assessed at baseline and at 1, 3, and 6 months. Results: Finerenone was discontinued in two patients (5.1%) due to flushing and headache. Severe hyperkalemia occurred in four patients (10.2%). In the finerenone group, proteinuria significantly decreased at all time points (p < 0.05), with a 40% reduction at six months. No significant changes in estimated glomerular filtration rate or serum creatinine were observed. Conclusions: Finerenone is a promising adjunct therapy in kidney transplant patients for reducing proteinuria without impairing renal function for those patients who can tolerate it. However, in the early phase of treatment initiation, patients should be closely monitored for adverse effects including hyperkalemia.
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Kahvecioğlu et al. (2025) conducted a cohort in Kidney transplant with proteinuria (n=30). Finerenone vs. Matched controls (standard care) was evaluated on Decrease in proteinuria at 6 months (p=<0.05). Finerenone significantly reduced proteinuria by 40% at six months compared to baseline in kidney transplant recipients, although this decrease was not statistically significantly different from the control group.
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