Kidney Week

Abstract: SA-PO0529

Effect of the Nonsteroidal Mineralocorticoid Receptor Antagonist Finerenone on Vasodilatory Function of Renal Vessels

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

• 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

• Pahl, Amrei, Universitatsklinikum Erlangen Medizinische Klinik 4 Nephrologie und Hypertensiologie, Erlangen, BY, Germany

Amrei Pahl

• 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 aim of this prospective, double-blind, placebo-controlled, randomized study was to analyze the effect of finerenone on the vasodilatory function of renal vessels.

Methods

Patients with T2D were randomized to receive either finerenone (n=37) or placebo (n=41) for 12 weeks. The vasodilatory function of the renal vessels was analyzed by measuring renal plasma flow (RPF) using the constant-infusion input-clearance technique with para-aminohippuric acid before and after provocative testing: 1. L-arginine infusion (100 mg/kg body weight; nitric oxide-dependent vasodilation), and 2. in addition vitamin C infusion (3 g; attenuation of renal oxidative stress) at baseline and 12 weeks after randomization.

Results

The mean age of patients with T2D (disease duration 11.8 ± 6.7 years) was 64.8 ± 6.4 years with mean estimated glomerular filtration rate (eGFR) of 80.9 ± 13.7 ml/min/1.73 m². The majority of patients (87.2%) were on metformin therapy and 54% were on SGLT-2 inhibitor therapy, with no patient receiving insulin therapy. Change in RPF following L-arginine infusion in the finerenone group was not different to the placebo group (p=0.116). Change in RPF due to vitamin C infusion on top of L-arginine from the value of L-arginine infusion was different between the groups (p=0.011). Change in RPF due to the L-arginine and vitamin C infusion from baseline was different between groups (p=0.006). No relevant hyperkalemia (>5.5 mmol/l) has been noted with finerenone treatment.

Conclusion

In patients with T2D, treatment with finerenone resulted in an improvement in the vasodilatory function of renal vessels compared to placebo. This finding provides at least a partial explanation for the nephroprotective effect of finerenone.

Funding

• Commercial Support – Bayer