Finerenone in Type 1 Diabetes and Chronic Kidney Disease
Primary result · Relative change in urinary albumin-to-creatinine ratioResult — go to the resultGeometric mean ratio 0.75 95% CI 0.65–0.87Authors' conclusion
In adults with type 1 diabetes and CKD, finerenone resulted in a significantly greater decrease in the urinary albumin-to-creatinine ratio than placebo.
Study context
- Population
- Adults with T1D, chronic kidney disease (CKD) (eGFR 25 to <90 ml/min/1.73 m²) and albuminuria (urinary albumin-to-creatinine ratio 200 to <5000) receiving an angiotensin-converting-enzyme (ACE) inhibitor or angiotensin-receptor blockerrandomized
- Participants
- 242 adults
- Comparison
- Finerenone vs placebo
- Primary endpoint
- Relative change in the urinary albumin-to-creatinine ratio
- Follow-up
- 6 months
Methodological detailsphase 3, placebo-controlled
- Phase 3
- Placebo-controlled
Primary result
As reported in the abstract
Relative change in urinary albumin-to-creatinine ratio
Geometric mean ratio
0.75
95% CI 0.65–0.87
P < 0.001
Change by group
Finerenone
0.66
geometric mean ratio to baseline · 95% CI 0.60–0.73
Placebo
0.88
geometric mean ratio to baseline · 95% CI 0.79–0.98
Finerenonevs Placebo
geometric mean ratio 0.75 (95% CI 0.65–0.87); P < 0.001
Further findings
Median urinary albumin-to-creatinine ratio, baseline to 6 months
- Finerenone: baseline to 6 months
- 574.6 to 373.5
- Placebo: baseline to 6 months
- 506.4 to 475.6
Safety
Hyperkalemia (most common adverse event)
ml per minute per 1.73 m²
| Outcome | Finerenone | Placebo | Difference (ml per minute per 1.73 m²) (95% CI) | |
|---|---|---|---|---|
| Change in eGFR · 6 months | −5.6 | −2.7 | −2.9 (−5.1 to −0.7) | |
| −10−505Difference, ml per minute per 1.73 m² (linear scale) |
- Hyperkalemia (most common adverse event) — Discontinued finerenone because of hyperkalemia
- 2 participants (1.7%)
Change in eGFR · 6 months
- eGFR values approached baseline levels during the washout period
Original publication
Finerenone in Type 1 Diabetes and Chronic Kidney Disease. N Engl J Med. Published 5 March 2026. doi:10.
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