Kidney Week

Abstract: TH-PO1062

Finerenone Reduces Proteinuria in Kidney Transplant Recipients Without Compromising Kidney Function

Session Information

• Transplantation: Clinical - Outcomes, Malignancy, and Pathology
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2002 Transplantation: Clinical

Authors

• Kahvecioglu, Serdar, TC Saglik Bakanligi SBU Bursa Yuksek Ihtisas Egitim ve Arastirma Hastanesi, Bursa, Turkey

Serdar Kahvecioglu, MD, DrMed

• Celik, Huseyin, Acibadem Saglik Grubu, Istanbul, Turkey

Huseyin Celik

• Karatutlu, Asena Serap, TC Saglik Bakanligi SBU Bursa Yuksek Ihtisas Egitim ve Arastirma Hastanesi, Bursa, Turkey

Asena Serap Karatutlu, MD

• Aktas, Nimet, TC Saglik Bakanligi SBU Bursa Yuksek Ihtisas Egitim ve Arastirma Hastanesi, Bursa, Turkey

Nimet Aktas, MD

• Akarsu, Ozger, TC Saglik Bakanligi SBU Bursa Yuksek Ihtisas Egitim ve Arastirma Hastanesi, Bursa, Turkey

Ozger Akarsu, MD

Background

Proteinuria is a key predictor of graft dysfunction and long-term graft loss in kidney transplant recipients. Finerenone, a selective non-steroidal mineralocorticoid receptor antagonist, has demonstrated renoprotective effects in chronic kidney disease populations; however, transplant recipients have been excluded from major trials, and real-world evidence in this population remains limited.

Methods

In this retrospective, two-center study, 1,750 kidney transplant recipients were screened. Fifteen patients who received finerenone for at least 6 months were compared with 15 matched controls. Proteinuria, serum creatinine, estimated glomerular filtration rate (eGFR), and potassium levels were evaluated at baseline, 1, 3, and 6 months. Non-parametric tests were used, including Friedman and Wilcoxon tests for within-group comparisons and Mann–Whitney U test for between-group analyses.

Results

Baseline demographic and clinical characteristics were comparable between groups. In the finerenone group, proteinuria significantly decreased at all follow-up time points (p<0.05), with an approximate 40% reduction at 6 months. The reduction was most pronounced at 1 month (p=0.002) and remained significant at 3 and 6 months.
Renal function remained stable in the finerenone group, with no significant changes in serum creatinine or eGFR. In contrast, the control group demonstrated a significant increase in creatinine and decline in eGFR at 6 months.
Finerenone was discontinued in 10.2% of patients due to hyperkalemia. Mild, transient increases in potassium were observed early in treatment but resolved over time. No cases of severe clinical complications requiring hospitalization were reported.

Conclusion

Finerenone significantly reduces proteinuria in kidney transplant recipients without adversely affecting renal function. Despite a moderate risk of hyperkalemia, particularly in the early phase, the drug appears to be a promising adjunctive therapy in this high-risk population. Larger prospective studies are warranted.

Acknowledgment

We gratefully acknowledge the contributions of all clinical staff and research coordinators involved in patient recruitment and data collection. We extend our sincere appreciation to the nephrology department for their unwavering support throughout this study. Special thanks to our patients, whose participation made this research possible.