Abstract: SA-PO0525
Novel Integration of Pathologic Features in Assessing Finerenone for CKD: Effectiveness and Safety from a Retrospective, Real-World Study
Session Information
- CKD: Clinical - Therapies, CKM Health, Special Populations, and More
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2202 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Jia, Xiaoyuan, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Zhang, Fan, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Li, Ping, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Wang, Shuqiang, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Xiong, Zibo, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Hou, Shuang, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
Background
Chronic kidney disease (CKD) arises from heterogeneous etiologies, yet its progression is driven by shared mechanisms including inflammation, fibrosis and mineralocorticoid receptor overactivation. Finerenone has demonstrated efficacy in proteinuria control and renal protection in CKD patients.
Methods
This retrospective study included CKD patients who initiated finerenone at Peking University Shenzhen Hospital (Jan 2023–Jul 2025). Exclusion criteria included concomitant glucocorticoid/immunosuppressive therapy or anti-CD20 antibody treatment within 6 months. Pathological parameters were reassessed using a standardized scoring system in patients with available prior kidney biopsy. Glomerular lesions (global/segmental sclerosis, crescents) and tubulointerstitial/vascular lesions (Tervaert classification) were evaluated.
Results
We included 205 patients with a mean follow-up period of 9.6 months. Linear mixed model showed significant UPCR reductions from baseline: 29.0%, 35.0%, 40.2%, and 47.9% at 3, 6, 9, and 12 months (all P<0.05). eGFR showed a slight downward trend (reductions of 4.6%, 5.9%, 7.6%, and 5.6% at 3, 6, 9, 12 months; all P<0.05). Serum potassium increased slightly (2-3%). Among 83 patients with pathological analysis, interstitial inflammation (≥25% vs <25%) was associated with poor proteinuria reduction (exp[β]=1.45, P=0.0082), while higher C3 immunofluorescence was associated with greater proteinuria reduction (exp[β]=0.90,P=0.0311).
Conclusion
This study confirmed the proteinuria reduction effect of finerenone in CKD paitents regrdsless the etiologies.We reported the associations of interstitial inflammation and immunofluorescence C3 level with response to finerenone treatment.
Acknowledgment
This study was supported by 1) the Key Program for Clinical Research at Peking University Shenzhen Hospital (LCYJZD2021001) and 2) Funding of Shenzhen Clinical Research Center for Urology and Nephrology,Grant No.LCYSSQ20220823091403008.
Baseline information
| Group | Non-specific CKD (N=114) | MN (N=30) | IgAN (N=61) | |
| Male:Female | 61:53 | 20:10 | 26:35 | |
| Age [Median (Q1,Q3)] | 54 (40,61) | 53.5 (40,63) | 41 (34,50) | |
| Hypertention [%] | 50.0% | 43.3% | 36.1% | |
| T2D [%] | 57.9% | 23.3% | 11.5% | |
| RASi [%] | 93.9% | 100% | 96.7% | |
| SGLT2i [%] | 58.8% | 63.3% | 78.7% | |
| UPCR [Median (Q1,Q3)] (g/g) | 1.24 (0.68,2.46) | 2.64 (1.68,4.17) | 1.18 (0.78, 1.89) | |
| eGFR [Median (Q1,Q3)](ml/min/1.73m2) | 54.2 (40.1,79.0) | 89.4 (74,109.5) | 65.8 (43.3, 77.7) | |
| Serum potassium [Average (SD)] (mmol/L) | 4.25 (0.38) | 4.12 (0.37) | 4.19 (0.26) | |
Funding
- Government Support – Non-U.S.