Abstract: SA-PO0530
Effect of Finerenone on Risk Biomarkers of CKD Progression: 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
- Berger, Mario, Bayer AG, Wuppertal, NRW, Germany
- Agarwal, Rajiv, Division of Nephrology, Richard L. Roudebush VA Medical Center, Indiana University School of Medicine, Indianapolis, Indiana, United States
- Cherney, David, Division of Nephrology, University Health Network, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
- Lam, Carolyn S.P., National Heart Centre Singapore, Singapore, Singapore
- Neuen, Brendon Lange, Renal and Metabolic Division, George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- Perkovic, Vlado, University of New South Wales, Sydney, New South Wales, Australia
- Tuttle, Katherine R., Providence Inland Northwest Health, University of Washington School of Medicine, Spokane, Washington, United States
- Wanner, Christoph, Department of Clinical Research and Epidemiology, Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany
- Heerspink, Hiddo Jan L., University Medical Center Groningen, Groningen, Netherlands
Background
The phase 3 FIND-CKD trial investigated the effect of the non-steroidal mineralocorticoid receptor antagonist (MRA) finerenone on kidney disease progression in patients with non-diabetic chronic kidney disease (CKD). Here, we explored the effect of finerenone on circulating biomarkers and their association with CKD progression.
Methods
Biosamples from all 660 trial participants with a biopsy-proven diagnosis who consented to biomarker sampling were included in this analysis. The parent trial randomized subjects to finerenone or placebo (1:1). Pre - and up to three post-randomization plasma samples (months 3, 12 and 24) were analyzed on Olink's ExploreHT platform. More than 5,000 proteins were measured. Biomarkers with a significant difference between treatment arms, based on mixed models for repeated measurements adjusted for age and sex, were considered treatment-responsive to finerenone. Biomarker levels were associated with clinical outcomes by linear (total eGFR slope) and Cox regression models.
Results
The mean age of the participants in this study was 51.5 years, 39% were female, all had non-diabetic CKD. At baseline, the mean estimated glomerular filtration rate (eGFR) was 48.4 mL/min/1.73 m2 (standard deviation, SD, 16.4), and the mean urinary albumin-to-creatinine ratio (UACR) was 1039 mg/g (SD, 620). Most frequent etiologies were IgA nephropathy (45%) and focal segmental glomerulosclerosis (24%). Renin was consistently upregulated by finerenone versus placebo while KIM-1 and the remodeling marker CSPG4 were among the most downregulated biomarkers. Proteins downregulated by finerenone appeared to be associated with better outcomes - if reduced - in time-to-event and regression analysis. This association remained after adjusting for covariates, including baseline albuminuria, uric acid, hemoglobin, or blood pressure.
Conclusion
This study provides insights into the longitudinal changes of circulating biomarkers - beyond commonly used markers of kidney damage - in patients with non-diabetic CKD when treated with finerenone. Plasma biomarkers which were positively associated with CKD progression in this cohort were more likely to be downregulated which may be reflective of the clinical benefits observed in FIND-CKD.
Acknowledgment
The authors and study sponsor thank the patients for their participation in this study, and the study personnel.
Funding
- Commercial Support – The study and this analysis were funded by Bayer AG, Pharmaceuticals, Berlin, Germany.