At the European Renal Association Congress in Glasgow, researchers unveiled results from three landmark studies that could reshape treatment for one of the world's most common diseases: a kidney drug called finerenone now shows promise far beyond its current use, offering hope to millions of patients who have few options today.
Chronic kidney disease affects roughly one in ten people globally—about 850 million individuals—and is already a leading cause of death and disability. The urgency is mounting: by 2040, CKD is projected to become the fifth largest contributor to premature death worldwide. Yet most people living with CKD don't have diabetes, the main cause for which finerenone is currently approved, and they face limited effective treatments. This gap in care is what the new research addresses.
Finerenone, a non-steroidal mineralocorticoid receptor antagonist, works by blocking a receptor that drives inflammation and fibrosis across many forms of kidney disease. The three studies—presented simultaneously and published in The Lancet, The New England Journal of Medicine, and JAMA, a rare achievement in clinical research—demonstrate its power across a much broader patient population than previously indicated.
The FIND-CKD trial, led by Professor Hiddo Heerspink at The George Institute and Professor Vlado Perkovic at UNSW Sydney, enrolled 1,584 patients with non-diabetic CKD across 24 countries. When added to standard care, finerenone significantly slowed the decline in kidney function and reduced the risk of kidney failure, CKD progression, heart failure, or cardiovascular death by 23 percent. For a disease with such limited options, this margin represents meaningful protection.
In patients with glomerular diseases—a subset characterized by immune-mediated kidney damage and even fewer treatment choices—the benefits were even more striking. Finerenone reduced the risk of kidney failure or CKD progression by 26 percent and lowered albuminuria, a key marker of kidney damage, by 42 percent at 12 months.
A third analysis pooled data from FIND-CKD with two prior trials in diabetic CKD, creating a dataset of 14,574 patients with both diabetic and non-diabetic kidney disease. Across this diverse group, finerenone reduced the risk of kidney failure or CKD progression by 24 percent, hospitalization for heart failure or cardiovascular death by 20 percent, and all-cause death by 12 percent. Remarkably, these benefits held regardless of diabetes status, the underlying kidney disease, or how much kidney function patients had lost.
Safety remained a concern worth monitoring: hyperkalemia, or high blood potassium levels, occurred more frequently with finerenone than placebo. However, rates of treatment discontinuation and hospitalization due to hyperkalemia were low, suggesting the risk is manageable with appropriate monitoring.
Associate Professor Brendon Neuen, lead global clinical trialist at The George Institute, framed the findings as a watershed moment. The research suggests that expanding finerenone use has the potential to meaningfully reduce kidney failure and cardiovascular complications for millions worldwide. For patients with non-diabetic CKD who currently lack effective options, these results offer something rare: evidence that a new tool can genuinely change the trajectory of their disease.