Kidney Week

Abstract: TH-PO1253

Finerenone in Patients with IgA Nephropathy: A FIND-CKD Analysis

Session Information

• Late-Breaking Research Posters
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• 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

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

Hiddo Jan L. Heerspink, PharmD, PhD

• Agarwal, Rajiv, Richard L. Roudebush VA Medical Center, Indiana University School of Medicine, 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 Department of Cardiology, Singapore, Singapore

Carolyn S.P. Lam, MBBS, PhD

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

Katherine R. Tuttle, MD, FASN

• Wanner, Christoph, Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany

Christoph Wanner, MD

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

Pantelis Sarafidis, MD, PhD

• Suzuki, Yusuke, Juntendo University Faculty of Medicine, Tokyo, Japan

Yusuke Suzuki, MD, PhD

• Barratt, Jonathan, University of Leicester and Leicester General Hospital, Leicester, United Kingdom

Jonathan Barratt, MBChB, PhD

• Floege, Jürgen, RWTH Aachen University Hospital, Aachen, Germany

Jürgen Floege, MD

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

Niels Jongs, PhD

• Smeijer, Johannes David, University of Groningen, University Medical Center Groningen, Groningen, Netherlands

Johannes David Smeijer, MD, MSc

• Berger, Mario, Bayer AG, Wuppertal/Berlin, Germany

Mario Berger, MSc, PhD

• MacNamara, Aidan, Bayer AG, Wuppertal/Berlin, Germany

Aidan MacNamara, MSc, PhD

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

Meike Daniela Brinker, MD, DrMed

• Chen, Min, ICON Strategic Solutions, ICON Clinical Research Germany GmbH, Langen, Germany

Min Chen

• Dayoub, Rania, Global Medical & Evidence CV and Heme, Bayer AG, Berlin, Germany

Rania Dayoub, DrMed, PhD, RPh

• Schloemer, Patrick, Clinical Statistics and Analytics, Bayer AG, Berlin, Germany

Patrick Schloemer, PhD

• Perkovic, Vlado, George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia

Vlado Perkovic, MBBS, PhD, FASN

Background

The effects of finerenone on kidney outcomes in people with IgA nephropathy (IgAN), including on biomarkers that may elucidate its mechanisms of action, have not been comprehensively evaluated.

Methods

FIND-CKD was a randomized, double-blind, placebo-controlled trial evaluating finerenone in participants with non-diabetic CKD. In this analysis, we assessed the effects of finerenone on urine protein-to-creatinine ratio (UPCR), estimated glomerular filtration rate (eGFR) decline, and a range of immunological and kidney-injury associated biomarkers in participants with IgAN.

Results

Overall, 416/1584 (26%) participants had IgAN (93% with a kidney biopsy). Mean age was 48 years, 45% were female, and 75% were Asian. Mean eGFR was 49 mL/min/1.73 m² and median UPCR was 1122 mg/g. From baseline to Month 12, finerenone reduced UPCR vs placebo by 51% (95% CI 42–59). Finerenone also increased the likelihood of achieving UPCR <500 mg/g at Month 12 vs placebo (OR 6.8, 95% CI 3.7–13.1). The effect of finerenone on total eGFR slope (mL/min/1.73 m²/year) vs placebo was similar in participants with and without IgAN (0.6 [95% CI –0.1 to 1.3] vs 0.7 [95% CI 0.3–1.2]; p_interaction=0.755), as was the effect on the composite outcome of kidney failure or ≥40% decline in eGFR (HR 0.82, 95% CI 0.56–1.21 vs 0.73, 95% CI 0.58–0.93; p_interaction=0.762). Finerenone did not reduce circulating galactose-deficient IgA1 or other immunoglobulins, but did reduce several established plasma and urine biomarkers of kidney injury, particularly KIM-1 and urinary MMP7 (Fig 1.).

Conclusion

In people with IgAN, finerenone produces clinically meaningful reductions in proteinuria and attenuated eGFR decline through mechanisms that are likely distinct and complementary to those of immunological therapies for IgAN.

Funding

• Commercial Support – Bayer AG