Kidney Week

Abstract: FR-PO0497

Effects of the Nonsteroidal Mineralocorticoid Receptor Antagonist Finerenone on the Renal Hemodynamic and Intraglomerular Profile in Patients with Type 2 Diabetes

Session Information

• CKM: Clinical - Trials, Epidemiology, and Biomarkers
  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

• Kannenkeril, Dennis, Universitatsklinikum Erlangen Medizinische Klinik 4 Nephrologie und Hypertensiologie, Erlangen, BY, Germany

Dennis Kannenkeril, MD

• Bytyqi, Venera, Universitatsklinikum Erlangen Medizinische Klinik 4 Nephrologie und Hypertensiologie, Erlangen, BY, Germany

Venera Bytyqi, MD

• Striepe, Kristina, Universitatsklinikum Erlangen Medizinische Klinik 4 Nephrologie und Hypertensiologie, Erlangen, BY, Germany

Kristina Striepe, MD

• Bosch, Agnes, Universitatsklinikum Erlangen Medizinische Klinik 4 Nephrologie und Hypertensiologie, Erlangen, BY, Germany

Agnes Bosch, MD

• Kliem, Thorsten, Universitatsklinikum Erlangen Medizinische Klinik 4 Nephrologie und Hypertensiologie, Erlangen, BY, Germany

Thorsten Kliem, MD, DrMed

• Karg, Marina V., Universitatsklinikum Erlangen Medizinische Klinik 4 Nephrologie und Hypertensiologie, Erlangen, BY, Germany

Marina V. Karg, MD

• Schiffer, Mario, Universitatsklinikum Erlangen Medizinische Klinik 4 Nephrologie und Hypertensiologie, Erlangen, BY, Germany

Mario Schiffer, MD, MBA

• Schmieder, Roland E., Universitatsklinikum Erlangen Medizinische Klinik 4 Nephrologie und Hypertensiologie, Erlangen, BY, Germany

Roland E. Schmieder, MD, FASN

Background

In patients with type 2 diabetes (T2D) and chronic kidney disease (CKD), treatment with finerenone resulted in lower risk of CKD progression and cardiovascular events. The renal hemodynamics profile of finerenone treatment has not been evaluated in detail.

Methods

In this prospective, double-blind, placebo- controlled, randomized study patients with T2D were randomized to receive either finerenone (n=37) or placebo (n=41) for 12 weeks. Renal hemodynamics were assessed using the constant-infusion input-clearance technique with para-aminohippuric acid and iohexol for assessing renal plasma flow (RPF) and measured glomerular filtration rate (mGFR), respectively. Intraglomerular hemodynamics were calculated according the Gomez′ model.

Results

Treatment with finerenone improved RPF (p=0.005), without any change in mGFR (p=0.781) compared to placebo. Renal vascular resistance (RVR) and filtration fraction (FF) decreased with finerenone treatment (RVR: p=0.001, FF: p=0.011) compared to placebo. Analysis of intraglomerular hemodynamics revealed that finerenone tended to decrease resistance of afferent arteriole (RA) (p=0.079), and diminished resistance of efferent arterioles (RE) (p=0.016) compared to baseline. Consequently, intraglomerular pressure and transglomerular gradient (TGG) were reduced after treatment with finerenone compared to baseline. Both RA (p=0.014) and RE (p=0.019) and TGG (p=0.010) were reduced after treatment with finerenone compared to placebo.

Conclusion

In patients with T2D treatment with finerenone resulted in improvement of renal perfusion by reducing renal vascular resistance, predominantly at the postglomerular site. Our results suggest that these hemodynamic and intraglomerular effects contribute to the repeatedly observed nephroprotective effects of finerenone.

Funding

• Commercial Support – Bayer