Finerenone for IgA Nephropathy After Renin‐Angiotensin System Inhibitors Discontinuation: A Multicentre Retrospective Cohort Study
Authors' conclusion
Finerenone achieved short-term proteinuria reductions in RASi discontinued IgAN patients similar to those achieved with RASi monotherapy. Finerenone combined with RASi enhanced antiproteinuric efficacy while maintaining safety.
Study context
- Population
- Patients with primary IgA nephropathy, baseline estimated glomerular filtration rate (eGFR) ≥ 25 mL/min/1.73 m² and urinary total protein ≥ 0.5 g/daypropensity score matched
- Participants
- 258 patients
- Exposure
- Finerenone plus renin-angiotensin system inhibitor (RASi) vs finerenone vs RASi
- Finerenone plus RASin = 86
- Finerenonen = 86
- RASin = 86reference
- Outcome
- Percentage change in urinary total protein from baseline; rate of significant response (≥ 50% reduction in UTP and < 20% increase in serum creatinine)
- Follow-up
- 12 months
Methodological detailsmulticentre, 1:1:1 propensity score matching
- Multicentre
- 1:1:1 propensity score matching
Main finding
As reported in the abstract
Percentage change in UTP from baseline
Finerenone plus RASi
54.43%
Finerenone
32.24%
RASi
34.35%
Finerenone vs RASi: P = 0.220 · Finerenone plus RASi vs Finerenone or RASi: both p < 0.01
Observational data: associations, not effects.
Further findings
Chronic eGFR slope
mL/min/1.73 m²/year
| Outcome | Finerenone plus RASi | Finerenone | RASi |
|---|---|---|---|
| Total eGFR decline | −1.48 | −0.44 | −0.52 |
Total eGFR decline
- Difference not statistically significant vs finerenone or RASi
Chronic eGFR slope
- Difference not statistically significant vs finerenone or RASi
Safety
- Incidence of adverse events comparable across all three groups
Original publication
Finerenone for IgA Nephropathy After Renin‐Angiotensin System Inhibitors Discontinuation: A Multicentre Retrospective Cohort Study. Diabetes Obes Metab. Published 17 August 2026. doi:10.
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