Efficacy and safety of finerenone in diabetic kidney disease: Latin American experience from FINDKDLATAM trial

Arnedo R.D.; Polo V.S.; Garcia J.B.; Gutiérrez J.F.; Clason E.R.; Domínguez D.; Rebutti G.M.; Mancia C.M.; López R.T.; Meza M.R.; López D.T.; Zambrano J.J.M.; Herrera E.L.; Dina-Batlle E.; Terrones M.C.; Moraes T.P.; Yánez T.R.; Osorio W.; Cabeza A.A.; Rico-Fontalvo J. · World Journal of Nephrology (2026) · DOI: 10.5527/wjn.v15.i1.115933

Resumen

BACKGROUND Patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) face high renal and cardiovascular risks. Finerenone, a selective non-steroidal mineralocorticoid receptor antagonist, has demonstrated efficacy in reducing these risks in clinical trials. However, its real-world safety and effectiveness remain underex-plored in local settings. AIM To evaluate the real-world safety and effectiveness of finerenone in patients with T2DM and CKD across seven Latin American countries. METHODS We conducted an observational, multicenter, retrospective cohort study based on real-world data in 347 patients with T2DM and CKD [urinary albumin-creatinine ratio (UACR) > 30 mg/g]. Patients received finerenone (10 mg or 20 mg daily), and clinical and laboratory parameters were evaluated at baseline and after six months of treatment. RESULTS At baseline, median values (interquartile range) were: Glycated hemoglobin A1c 7.6% (6.8%-8.1%); estimated glomerular filtration rate 39.0 mL/minute/1.73 m2 (30.0-50.0); UACR 345 mg/g (189-760); systolic blood pressure 143 mmHg (130-160); diastolic blood pressure 79 mmHg (70-82); and serum potassium 4.4 mmol/L (4.1-4.7). After six months, significant reductions were observed: Glycated hemoglobin A1c to 7.0% (6.5%-7.9%); UACR to 81 mg/g (28-167); systolic blood pressure to 130 mmHg (120-140); and diastolic blood pressure to 73 mmHg (70-80). Serum potassium increased to 4.7 mmol/L (4.3-5.0), while estimated glomerular filtration rate remained stable at 41.6 mL/minute/1.73 m2 (27.0-52.0). CONCLUSION In our cohort of patients with CKD associated with T2DM, finerenone proved to be an effective short-term therapy for reducing albuminuria, demonstrating very good tolerance and a low risk of hyperkalemia. ©Author(s) 2026.

Instituciones: Universidad Peruana Cayetano Heredia