Finerenone reduces kidney risks by 23% in non-diabetic chronic kidney disease

Researchers have discovered that finerenone can slow the deterioration of kidney function and lower major health risks in individuals with chronic kidney disease (CKD) who do not have diabetes. This expands the potential use of the drug beyond its previously known benefits for diabetic kidney disease.

Chronic kidney disease affects around 800 million people worldwide and is a leading cause of kidney failure, cardiovascular issues, and early mortality. Treatment options for CKD patients without diabetes have been limited until now.

The international FIND-CKD trial, led by clinical pharmacologist Hiddo Lambers Heerspink from the University Medical Center Groningen, investigated finerenone’s effects on non-diabetic CKD patients. The study results were published in the New England Journal of Medicine.

Evaluating Finerenone’s Impact on Kidney Function

CKD is often described as a “silent” disease because symptoms may not appear until considerable kidney damage has occurred. As kidney function declines, patients face higher risks of kidney failure, heart disease, hospitalization, and death.

The trial enrolled 1,584 adults with CKD who did not have diabetes. All participants exhibited reduced kidney function and elevated protein levels in their urine, both markers of ongoing kidney damage. They received either finerenone or a placebo alongside standard treatments such as ACE inhibitors or angiotensin receptor blockers, commonly used to protect kidney function and manage blood pressure. The patients were monitored for an average of just over three years.

Slower Decline in Kidney Function and Reduced Complications

Kidney function was assessed over 2.5 years using estimated glomerular filtration rate (eGFR), which measures the kidneys’ ability to filter blood. Patients treated with finerenone experienced a significantly slower decline in eGFR compared to those given a placebo. Lambers Heerspink described the improvement as both statistically significant and clinically meaningful.

The treatment also decreased the risk of major kidney complications, hospitalizations for heart failure, and deaths from cardiovascular disease. According to Lambers Heerspink, “In the finerenone group, 13.9 percent experienced such a complication, compared to 16.9 percent in the placebo group. That amounts to a reduction in risk of approximately 23 percent.”

Reduction in Urinary Protein Levels

After six months of treatment, finerenone users showed notable decreases in protein levels in their urine. Lambers Heerspink explained, “Protein in the urine is often an early and important indicator of kidney damage. In the finerenone group, protein levels decreased by an average of over 41 percent, compared to about 9 percent in the placebo group. More than half of the patients receiving finerenone achieved at least a 30 percent reduction in urinary protein, which is a key sign of a better renal prognosis.”

Earlier large-scale studies had primarily focused on finerenone’s effects in patients with type 2 diabetes. Lambers Heerspink noted, “Now it turns out the drug is also effective in people without diabetes, even though more than half of all CKD patients worldwide are non-diabetic.”

Safety and Future Treatment Options

The study confirmed that finerenone is safe for use in patients with non-diabetic CKD. Lambers Heerspink stated, “Finerenone could become an important new treatment option for people with chronic kidney disease who do not have diabetes. It offers a clear delay in kidney function decline on top of current standard care. These results provide physicians with new therapeutic options to preserve kidney function and reduce cardiovascular and renal complications in a broad, underserved patient population with few existing guideline-recommended treatments.”

Reference: “Finerenone in Persons with Chronic Kidney Disease without Diabetes” by Hiddo J.L. Heerspink et al., New England Journal of Medicine, 3 June 2026. DOI: 10.1056/NEJMoa2604625