Finerenone in People with CKD, Type 2 Diabetes, and History of Nephrectomy.
Publication/Presentation Date
1-14-2026
Abstract
KEY POINTS: Finerenone reduced albuminuria versus placebo in patients with a history of nephrectomy, similar to those without a history of nephrectomy. Incidences of treatment-emergent adverse events or serious adverse events were generally similar in patients with and without history of nephrectomy. Finerenone may delay kidney disease progression in patients with CKD and type 2 diabetes, irrespective of nephrectomy status.
BACKGROUND: Finerenone significantly reduced the risk of cardiovascular and kidney outcomes in patients with CKD and type 2 diabetes (T2D) in FIDELITY, a prespecified pooled analysis of two phase 3 trials. This
METHODS: Patients in FIDELITY were randomized to receive finerenone or placebo and were on optimized renin–angiotensin system inhibition. We identified nephrectomy status using patients' medical history and assessed CKD progression in patients by nephrectomy status at baseline by modeling change in urine albumin-to-creatinine ratio from baseline to months 4–24. Safety outcomes included treatment-emergent adverse events and incident hyperkalemia.
RESULTS: Of 12,990 patients, 108 had a history of nephrectomy at baseline; 101 of 108 had radical nephrectomy, 55 received finerenone, and 53 received placebo. Baseline mean eGFR were numerically lower in patients with a history of nephrectomy (48±17 ml/min per 1.73 m
CONCLUSIONS: Finerenone reduced albuminuria compared with placebo and demonstrated a safety profile consistent with the overall FIDELITY population in patients with and without a history of nephrectomy at baseline. Finerenone may delay CKD progression and associated morbidity in patients with CKD and T2D, irrespective of nephrectomy status.
CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER:: FIDELIO-DKD (NCT02540993); FIGARO-DKD (NCT02545049).
Volume
21
Issue
3
First Page
414
Last Page
424
ISSN
1555-905X
Published In/Presented At
Mendoza, J. M., Weir, M. R., Anker, S. D., Filippatos, G., Rossing, P., Ahlers, C., Brinker, M., Fatoba, S. T., Horvat-Broecker, A., Rohwedder, K., Fornoni, A., & FIDELIO-DKD and FIGARO-DKD Investigators (2026). Finerenone in People with CKD, Type 2 Diabetes, and History of Nephrectomy. Clinical journal of the American Society of Nephrology : CJASN, 21(3), 414–424. Advance online publication. https://doi.org/10.2215/CJN.0000000932
Disciplines
Medicine and Health Sciences
PubMedID
41533467
Department(s)
Department of Medicine
Document Type
Article