Kidney Week

Abstract: FR-PO0572

Is Finerenone Safe on a High-Potassium Diet? Real-World Evidence from Patients with Diabetic Kidney Disease in the Dominican Republic

Session Information

• CKM: Clinical - Meta-Analyses, Predictive Modeling, Care Delivery, and Safety
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Martínez Peralta, Rafael, Hospital Salvador B. Gautier, Santo Domingo, Distrito Nacional, Dominican Republic

Rafael Martínez Peralta, MD

• Cuevas Budhart, Miguel Angel, Unidad de Investigación Médica en Enfermedades Nefrológicas, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico

Miguel Angel Cuevas Budhart, MS, MSc, PhD, RN

• Jimenez Ramirez, Rigoberto, Hospital Salvador B. Gautier, Santo Domingo, Distrito Nacional, Dominican Republic

Rigoberto Jimenez Ramirez, MD

• Campos, Erwin Iván, Hospital Salvador B. Gautier, Santo Domingo, Distrito Nacional, Dominican Republic

Erwin Iván Campos, MD

Group or Team Name

• Gautier

Background

Chronic kidney disease affects about 10% of the global population. Finerenone, a nonsteroidal mineralocorticoid receptor antagonist, has become a cornerstone in the treatment of diabetic kidney disease (DKD). However, hyperkalemia concerns limit its use, particularly in regions with high dietary potassium (K⁺) intake, such as the Dominican Republic (DR), where the consumption of plantains, bananas, and avocados is frequent. Real-world evidence evaluating finerenone's safety in this context remains limited.

Methods

This prospective observational study followed fifteen adult with DKD patients receiving finerenone in the DR for 3 months.
Clinical and laboratory parameters (SBP, DBP, MAP, serum K⁺, eGFR, UACR, HbA1c) were assessed at baseline, Month 1 to 3. Longitudinal comparisons were evaluated using the Friedman test for repeated measures (significance at p<0.05).

Results

Fifteen DKD patients (mean age 66.6±8.1 years; 60% male) were included. Baseline K⁺ was 4.61±0.43 mEq/L, eGFR 55.0±15.6 mL/min/1.73m², and UACR 354.3±407.1 mg/g.
Serum K⁺ remained stable without significant longitudinal changes (range: 4.52±0.34 – 4.66±0.37 mEq/L; p=0.791). By Month 3, UACR decreased 33% (401.27±399.60 to 267.78±353.23 mg/g; p<0.001) while eGFR was stable (57.27±16.04 to 55.93±14.48 mL/min/1.73 m²; p=0.402).
MAP decreased at Month 2 (112.80±14.26 to 102.67±13.94 mmHg; p=0.038), alongside SBP showed significant reductions (p=0.048); DBP was unchanged (p=0.327). No severe hyperkalemia or discontinuations occurred.

Conclusion

Finerenone can be safely used in DKD patients on high-potassium diets without destabilizing serum potassium. The substantial reduction in albuminuria alongside improved blood pressure underscores its nephroprotective profile, demonstrating that local dietary patterns should not preclude patients from receiving these benefits.

Acknowledgment

The authors extend their gratitude to Zaidy Aquino, all residents, staff nephrologists, and the patients of Hospital Salvador B. Gautier for the support provided throughout this study.

Figure 1. Longitudinal Changes in Serum Potassium, Albuminuria, and Kidney Function After Finerenone Initiation in CKD Patients Exposed to a High-Potassium Diet