The Efficacy of Finerenone for Non-Diabetic Kidney Disease: A Real-World Retrospective Study

The Efficacy of Finerenone for Non-Diabetic Kidney Disease: A Real-World Retrospective Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Efficacy of Finerenone for Non-Diabetic Kidney Disease: A Real-World Retrospective Study Xuejuan Sun, Juan Pei, Xing Chen, Zhi Wang, Lijing Yao, Peijin Bai, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8651150/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 14 You are reading this latest preprint version Abstract Background The purpose of this study was to evaluate the efficacy and safety of finerenone in patients with non-diabetic kidney disease. Methods This was a single-center retrospective study. The study included adults with non-diabetic kidney disease who were treated with finerenone between January 2023 and December 2025 and followed for at least 90 days. Results In this study of 122 patients, finerenone significantly reduced proteinuria, with a 34.46% median reduction in 24-hour urine protein (p < 0.001) and a decline in the urine albumin-to-creatinine ratio (ACR) from 585.99 mg/g to 295.68 mg/g at Month 24 (p = 0.006). The proportion of patients achieving a ≥ 50% reduction in proteinuria increased significantly to 45.00% by Month 24, with consistent efficacy observed in the subgroup not receiving immunosuppressive therapy. The estimated glomerular filtration rate (eGFR) trajectory showed an initial transient improvement at Month 6, followed by a later decline that subsequently stabilized. Hyperkalemia (serum potassium ≥ 5.5 mmol/L) occurred in 4.92% of patients, was manageable, and did not lead to treatment discontinuation. Conclusion Finerenone effectively reduced proteinuria in patients with non-diabetic kidney disease, with early efficacy that was maintained irrespective of immunosuppressive co-therapy. Treatment was associated with a manageable safety profile. Finerenone non-diabetic kidney disease 24-hour urinary protein glomerular filtration rate serum potassium Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 25 Mar, 2026 Reviews received at journal 23 Mar, 2026 Reviews received at journal 10 Mar, 2026 Reviewers agreed at journal 09 Mar, 2026 Reviews received at journal 06 Mar, 2026 Reviewers agreed at journal 06 Mar, 2026 Reviewers agreed at journal 05 Mar, 2026 Reviews received at journal 03 Mar, 2026 Reviewers agreed at journal 03 Mar, 2026 Reviewers agreed at journal 03 Mar, 2026 Reviewers invited by journal 03 Mar, 2026 Editor assigned by journal 27 Jan, 2026 Submission checks completed at journal 24 Jan, 2026 First submitted to journal 24 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8651150","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":581114946,"identity":"ebdc3568-f92c-40e9-a28e-75942deafccb","order_by":0,"name":"Xuejuan Sun","email":"","orcid":"","institution":"The First Affiliated Hospital of Xiamen University","correspondingAuthor":false,"prefix":"","firstName":"Xuejuan","middleName":"","lastName":"Sun","suffix":""},{"id":581114947,"identity":"73e08939-3d78-49ec-b492-d51689240f69","order_by":1,"name":"Juan Pei","email":"","orcid":"","institution":"The First Affiliated Hospital of Xiamen 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Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Finerenone, non-diabetic kidney disease, 24-hour urinary protein, glomerular filtration rate, serum potassium","lastPublishedDoi":"10.21203/rs.3.rs-8651150/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8651150/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe purpose of this study was to evaluate the efficacy and safety of finerenone in patients with non-diabetic kidney disease.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis was a single-center retrospective study. The study included adults with non-diabetic kidney disease who were treated with finerenone between January 2023 and December 2025 and followed for at least 90 days.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eIn this study of 122 patients, finerenone significantly reduced proteinuria, with a 34.46% median reduction in 24-hour urine protein (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and a decline in the urine albumin-to-creatinine ratio (ACR) from 585.99 mg/g to 295.68 mg/g at Month 24 (p\u0026thinsp;=\u0026thinsp;0.006). The proportion of patients achieving a\u0026thinsp;\u0026ge;\u0026thinsp;50% reduction in proteinuria increased significantly to 45.00% by Month 24, with consistent efficacy observed in the subgroup not receiving immunosuppressive therapy. The estimated glomerular filtration rate (eGFR) trajectory showed an initial transient improvement at Month 6, followed by a later decline that subsequently stabilized. Hyperkalemia (serum potassium\u0026thinsp;\u0026ge;\u0026thinsp;5.5 mmol/L) occurred in 4.92% of patients, was manageable, and did not lead to treatment discontinuation.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eFinerenone effectively reduced proteinuria in patients with non-diabetic kidney disease, with early efficacy that was maintained irrespective of immunosuppressive co-therapy. Treatment was associated with a manageable safety profile.\u003c/p\u003e","manuscriptTitle":"The Efficacy of Finerenone for Non-Diabetic Kidney Disease: A Real-World Retrospective Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-28 13:00:22","doi":"10.21203/rs.3.rs-8651150/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-25T05:03:43+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-24T00:30:16+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-10T11:47:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"48706046095612376562476934227554373577","date":"2026-03-09T14:15:00+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-07T03:03:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"253685226944940274616618913987870288288","date":"2026-03-07T02:36:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"170287481968337842441368618318108593995","date":"2026-03-05T17:24:27+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-03T19:26:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"238165170868370268331254308248416059011","date":"2026-03-03T11:31:41+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"8234560414085903908823448479249641203","date":"2026-03-03T11:24:27+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-03T10:55:46+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-27T11:24:45+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-25T03:00:59+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nephrology","date":"2026-01-25T02:56:12+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nephrology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bnep","sideBox":"Learn more about [BMC Nephrology](http://bmcnephrol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bnep/default.aspx","title":"BMC Nephrology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"77399a39-7da0-4614-8c09-031d0dc368de","owner":[],"postedDate":"January 28th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-26T08:53:10+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-28 13:00:22","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8651150","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8651150","identity":"rs-8651150","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}