Overview
- The phase III FIND‑CKD trial randomized 1,584 adults with eGFR 25–90 mL/min/1.73 m² and albuminuria to daily finerenone or placebo on top of standard renin‑angiotensin system blockade.
- Finerenone reduced the annual rate of eGFR decline by 0.7 mL/min/1.73 m² per year versus placebo, a statistically significant slowing reported in the New England Journal of Medicine and presented at the ERA Congress.
- The drug lowered a composite cardiovascular‑kidney outcome (kidney failure, large eGFR loss, heart‑failure hospitalization, or cardiovascular death) by about 23% versus placebo (HR 0.77).
- Benefit extended to patients with glomerular diseases and to those using or not using SGLT2 inhibitors, and finerenone reduced albuminuria by roughly 41–42% at around 6–12 months in subgroup analyses.
- Hyperkalaemia was the most common side effect, occurring more often with finerenone and causing more treatment discontinuations, and the trial excluded conditions such as polycystic kidney disease and lupus nephritis which limit broad applicability and will shape monitoring and guideline decisions.