Impact of Finerenone-Induced Albuminuria Reduction on Chronic Kidney Disease Outcomes in Type 2 Diabetes : A Mediation Analysis
Authors' conclusion
In patients with CKD and T2D, early albuminuria reduction accounted for a large proportion of the treatment effect against CKD progression and a modest proportion of the effect against cardiovascular outcomes.
Study context
- Population
- Patients with chronic kidney disease (CKD) and T2D, clinical sites in 48 countries; baseline median urine albumin-to-creatinine ratio (UACR) 514 mg/g
- Participants
- 12,512 patients
- Comparison
- Finerenone vs placebo
- Primary endpoint
- Proportion of kidney and cardiovascular risk reductions mediated by change in log UACR between baseline and month 4 (composite kidney and composite cardiovascular outcomes)
- Follow-up
- 4-year period
Methodological detailsdouble-blind, multinational (48 countries)
- Double-blind
- Multinational (48 countries)
Primary result
As reported in the abstract
Proportion of treatment effect mediated by UACR reduction
Mediated by UACR reduction (continuous) — composite kidney outcome
84%
Mediated by UACR reduction (continuous) — composite cardiovascular outcome
37%
Mediated by UACR reduction ≥30% (binary) — composite kidney outcome
64%
Mediated by UACR reduction ≥30% (binary) — composite cardiovascular outcome
26%
Further findings
UACR reduction ≥30%
Original publication
Impact of Finerenone-Induced Albuminuria Reduction on Chronic Kidney Disease Outcomes in Type 2 Diabetes : A Mediation Analysis. Ann Intern Med. Published 5 December 2023. doi:10.
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