Clinical Characteristics, Effectiveness and Safety Outcomes in Chinese Patients With Chronic Kidney Disease and Type 2 Diabetes Who Initiated Finerenone: A Retrospective Real‐World Cohort Study From the FOUNTAIN Platform

Aims Finerenone was approved in China in 2022 for adult patients with chronic kidney disease (CKD) associated with Type 2 diabetes (T2D). This study aimed to characterize Chinese patients with CKD and T2D who initiated finerenone in routine clinical practice and to evaluate treatment outcomes. Materials and Methods This retrospective study used electronic health records from Tianjin, China, and included adult patients with CKD and T2D who initiated finerenone between January 2023 and December 2024. Baseline characteristics were summarized. Relative changes in urinary albumin‐to‐creatinine ratio (UACR), estimated glomerular filtration rate (eGFR) and serum potassium were assessed. Recorded hyperkalaemia events were evaluated during follow‐up. Key outcomes were examined in the overall cohort and across subgroups. Results A total of 6537 patients were included (66.4% male; mean age 57.6 years). Of these, 97.0% with baseline UACR and eGFR values were categorized as moderate, high, or very high Kidney Disease: Improving Global Outcomes (KDIGO) risk categories. At Month 4, median UACR decreased substantially by 40.7% (95% confidence interval [CI]: 32.2%, 49.1%), the mean eGFR declined slightly by 3.2% (95% CI: 2.4%, 4.0%) and the mean serum potassium increased by 4.6% (95% CI: 3.9%, 5.3%). These trends were generally consistent across subgroups. The incidence rate of hyperkalaemia events was 4.1 per 100 person‐years. Conclusions Patients with CKD and T2D who initiated finerenone experienced a substantial reduction in UACR, a slight decrease in eGFR, and were generally well tolerated during follow‐up. These findings reinforce the effectiveness and safety of finerenone in Chinese real‐world clinical practice.