Kidney Week

Abstract: SA-PO0526

Effects of Finerenone on Clinical Outcomes by CKD Severity: A FIND-CKD Analysis

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

• Tuttle, Katherine R., Providence Inland Northwest Health, University of Washington School of Medicine, Spokane, Washington, United States

Katherine R. Tuttle, MD, FASN

• Agarwal, Rajiv, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, United States

Rajiv Agarwal, MD, MS, FASN

• Cherney, David, University Health Network, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada

David Cherney, MD, PhD

• Lam, Carolyn S.P., National Heart Centre Singapore, Singapore, Singapore

Carolyn S.P. Lam, MBBS, PhD

• Neuen, Brendon Lange, George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia

Brendon Lange Neuen, MBBS, MS, PhD, FASN

• Perkovic, Vlado, University of New South Wales, Sydney, New South Wales, Australia

Vlado Perkovic, MBBS, PhD, FASN

• Sarafidis, Pantelis, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece

Pantelis Sarafidis, MD, PhD

• Jongs, Niels, University of Groningen, University Medical Center Groningen, Groningen, Netherlands

Niels Jongs, PhD

• Brinker, Meike Daniela, Bayer AG, Wuppertal, Germany

Meike Daniela Brinker, MD, DrMed

• Heerspink, Hiddo Jan L., George Institute for Global Health, University of New South Wales, Sydney, Australia

Hiddo Jan L. Heerspink, PharmD, PhD

Background

Kidney and cardiovascular (CV) risks rise progressively with increasing chronic kidney disease (CKD) severity. In the phase 3 FIND-CKD trial, the nonsteroidal mineralocorticoid receptor antagonist finerenone reduced these risks in patients with non-diabetic CKD. The aim of this FIND-CKD analysis was to determine the effects of finerenone on kidney, CV, and safety outcomes by baseline estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR).

Methods

Patients with CKD (eGFR, 25 to <90 mL/min/1.73 m²), albuminuria (UACR 200 to ≤3500 mg/g), and on optimized renin–angiotensin system blockade were randomized 1:1 to finerenone or placebo. Outcomes assessed were the mean annual rate of eGFR change from baseline to month 32, time-to-event analyses of a composite kidney-CV (sustained ≥57% [eGFR] or kidney failure, heart failure hospitalization or CV death) and adverse events.

Results

Among 1584 patients analyzed, finerenone reduced the rate of total eGFR decline and the risk of composite kidney-CV outcome vs placebo, irrespective of baseline eGFR and UACR (Figure). Hyperkalemia was more frequent with finerenone vs placebo and this effect was consistent across CKD severity groups. Rates were 5.7% with finerenone and 5.8% with placebo in the least severe group; respective rates in the most severe group were 29.4% and 20.6%. Hyperkalemia incidence leading to hospitalization was low.

Conclusion

In patients with non-diabetic CKD, finerenone reduced the risks of kidney and CV outcomes without unexpected safety signals across a broad spectrum of CKD severity.

Funding

• Commercial Support – Bayer AG