Background: Given the inconsistence of real-world treatment with randomized controlled trials (RCTs) and guidelines, the risk of cardiovascular-renal events remains in patients with T2DM and CKD. This study aimed to assess the real-world effectiveness of finerenone in patients with T2DM and CKD in Peking University First Hospital.
Methods: This retrospective study included patients with T2DM and CKD treated with finerenone. Urinary albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), and serum potassium were recorded at baseline and post-finerenone treatment.
Results: Of the 93 patients, mean age was 59.5±8.5 years, 55 (59.1%) were male, and mean duration of T2DM was 13.0±7.2 years. Of these patients, 83.9% were on sodium-glucose co-transporter type-2 inhibitors, 43.0% on glucagon-like peptide-1 receptor agonists, 48.4% on insulin and 85.3% on renin-angiotensin system inhibitors. Baseline UACR was 408.0±449.4 mg/g, and 66% of patients had microproteinuria (30-299 mg/g). With finerenone administered mean daily dose at 14.6 mg for averagely 3.4 months, UACR decreased by 22.3% to 317.3±294.5 mg/g. eGFR decreased from 83.7±11.4 to 74.4±12.9 mL/min/1.73 m2 in patients with baseline eGFR>60 mL/min/1.73 m2 (75.3% of the total population). In patients with baseline eGFR<60 mL/min/1.73 m2 (24.7% of the total population), eGFR remained stable (49.2±6.6 vs. 49.0±6.1 mL/min/1.73 m2). Serum potassium slightly increased from 4.3±0.4 to 4.5±0.6 mmol/L and no adverse event of hyperkaliemia occurred.
Conclusion: Despite the different treatment background and finerenone use between the real-word clinical practice and RCTs, similar UACR reduction was observed in this study compared to FIGARO-DKD trials. Finerenone might improve proteinuria control and could be a promising treatment option to reduce the risk of cardiovascular-renal events in patients with T2DM and CKD in the integrated management.
A. Li: None. Y. Gao: None. X. Guo: None. J. Zhang: None.
