Kidney Week

Abstract: FR-PO0205

Finerenone, a Nonsteroidal Mineralocorticoid Receptor Antagonist, Improves Low-Renin Diabetic Nephropathy

Session Information

• Diabetic Kidney Disease: Metabolic, Mitochondrial, and Inflammatory Mechanisms
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 601 Cardiovascular-Kidney-Metabolic Health: Basic

Authors

• Shirozu, Takahiro, Fujita Health University, Toyoake, Aichi, Japan

Takahiro Shirozu, PhD

• Yoshimura, Aya, Fujita Health University, Toyoake, Aichi, Japan

Aya Yoshimura, PhD

• Kugita, Masanori, Fujita Health University, Toyoake, Aichi, Japan

Masanori Kugita, PhD

• Yatsushiro, Yuriko, CMIC Pharma Science Co., Ltd., Hokuto, Yamanashi, Japan

Yuriko Yatsushiro

• Shirakura, Miu, CMIC Pharma Science Co., Ltd., Hokuto, Yamanashi, Japan

Miu Shirakura

• Ohata, Keiichi, CMIC Holdings Co., Ltd., Minatoku, Tokyo, Japan

Keiichi Ohata, MS

• Fujiwara, Atsushi, CMIC Pharma Science Co., Ltd., Hokuto, Yamanashi, Japan

Atsushi Fujiwara, PhD

• Akie, Yasuki, CMIC Pharma Science Co., Ltd., Hokuto, Yamanashi, Japan

Yasuki Akie

• Yamaguchi, Tamio, Fujita Health University, Toyoake, Aichi, Japan

Tamio Yamaguchi, PhD

• Takahashi, Kazuo, Fujita Health University, Toyoake, Aichi, Japan

Kazuo Takahashi, MD, PhD

• Nagao, Shizuko, Fujita Health University, Toyoake, Aichi, Japan

Shizuko Nagao, PhD

Background

Spontaneously Diabetic Torii (SDT) fatty rats develop diabetic nephropathy with hyporeninemic hypertension after salt loading. We previously showed that finerenone (FIN), a nonsteroidal mineralocorticoid receptor (MR) antagonist, exerts antihypertensive and renoprotective effects in this model. This study evaluated the efficacy and safety of prolonged FIN treatment with or without the selective endothelin-A receptor antagonist ambrisentan (AMB).

Methods

Male SDT fatty rats (n = 20) were assigned to four groups: untreated, salt loading (0.3% NaCl), salt + FIN (10 mg/kg/day), and salt + FIN + AMB (5 mg/kg/day). During the 7-week administration period, treatment effects were evaluated based on blood pressure (BP), urinary albumin-to-creatinine ratio (ACR), urinary liver-type fatty acid binding protein-to-creatinine ratio (L-FABPCR), metabolic parameters, serum potassium, histology, and RNA sequencing. Differentially expressed genes (DEGs) were analyzed using Metascape.

Results

FIN and FIN + AMB significantly suppressed increases in BP, ACR, L-FABPCR, total cholesterol, and triglycerides compared with the salt-loading group. Severe glomerular injury and renal fibrosis induced by salt loading were markedly attenuated by treatment. DEGs normalized by treatment were predominantly associated with inflammatory pathways. No significant difference was observed in serum potassium concentration between the groups. Combination therapy did not provide significant additive benefits over FIN monotherapy.

Conclusion

Finerenone monotherapy exerted potent antihypertensive, renoprotective, and lipid metabolism-improving effects without significant adverse effects, supporting its potential as a first-line therapy for low-renin diabetic nephropathy. Early MR-targeted intervention may represent an effective therapeutic strategy in this condition.

Funding

• Government Support – Non-U.S.