At a medical congress in Glasgow, researchers unveiled findings that could shift the lives of millions: a kidney drug called finerenone appears to work far beyond the patients doctors thought it could help.
The discovery matters because chronic kidney disease affects roughly one in ten people worldwide—about 850 million individuals. Most of them don't have diabetes, and most have few effective treatment options. As kidney disease progresses, the risk of hospitalization, cardiovascular complications, and death rises sharply, making early intervention critical. The disease is projected to become the fifth leading cause of premature death globally by 2040, yet treatment options remain limited for the majority.
Finerenone was already approved to treat kidney disease in people with type 2 diabetes. But researchers from The George Institute for Global Health, led by Professor Hiddo Heerspink and Professor Vlado Perkovic of UNSW Sydney, began asking a larger question: could this drug help the millions living with non-diabetic kidney disease and other forms of the condition?
The FIND-CKD trial enrolled 1,584 people with non-diabetic chronic kidney disease across 24 countries. Those who received finerenone alongside standard treatment experienced significantly slower decline in kidney function compared with those receiving standard care alone. The medication reduced the combined risk of kidney failure, worsening disease, heart failure, or cardiovascular death by 23 percent. That single finding, published in The New England Journal of Medicine, suggested the drug's potential extended far beyond current treatment guidelines.
A second investigation focused on a particularly challenging subset: patients with glomerular diseases, immune-related conditions that damage the kidney's filtering units and have historically offered few treatment paths. Among these patients, finerenone lowered the risk of kidney failure or disease progression by 26 percent compared with placebo. The drug also reduced albuminuria—a measure of protein in the urine and a key indicator of kidney damage—by 42 percent after 12 months.
When researchers pooled data from 14,574 participants across both diabetic and non-diabetic chronic kidney disease populations, the benefits persisted. Finerenone reduced the risk of kidney failure or disease progression by 24 percent, lowered the risk of hospitalization for heart failure or cardiovascular death by 20 percent, and reduced the risk of death from any cause by 12 percent. Strikingly, these benefits remained consistent regardless of whether patients had diabetes, what type of kidney disease they had, or their level of kidney function.
The three studies were published simultaneously in The Lancet, The New England Journal of Medicine, and JAMA—an uncommon milestone in clinical research that underscores the significance of the findings. Associate Professor Brendon Neuen of The George Institute noted that finerenone was generally well tolerated, though elevated blood potassium levels occurred more frequently among those taking the drug. However, treatment discontinuation and hospitalizations related to this side effect were rare.
The implications are staggering. "Expanding the use of finerenone in patients with CKD has the potential to meaningfully reduce kidney failure and cardiovascular complications for millions of people worldwide," Neuen said. For the 850 million people living with kidney disease today—most of them without effective options—these results open a door.