Effectiveness and safety of finerenone in the treatment of IgA Nephrology patients: a retrospective, real-world study

PurposeThe proteinuria is closely related to the prognosis of IgA nephropathy (IgAN) patients. Finerenone has been demonstrated to reduce proteinuria in diabetic kidney disease (DKD). However, the role of finerenone in IgAN has not been reported. This study is to analyze the efficacy and safety of finerenone in IgAN.MethodsThis retrospective study analyzed IgAN patients' data post-finerenone treatment, with groups defined by treatment plans at baseline. It observed changes in the urinary albumin-to-creatinine ratio (UACR), the estimated glomerular filtration rate (eGFR), and serum potassium (sK+) levels over a 3-6 months follow-up.ResultsTotally 49 patients had follow-up data at 3 months, and 21 of which had data at 6 months. The median UACR at baseline was 494.25 mg/g. At 1 month, the median UACR decreased by 113 mg/g. At 3 months, the median UACR further decreased by 236.19 mg/g, and the median decrease percentage was 42.29%. At 6 months, the median UACR decreased by 203.88 mg/g, with the median decrease percentage of 41.86%. The average eGFR at baseline was 64.14 +/- 19.74 mL/min/1.73 m2. At 6 months, the eGFR showed a minor increase, although it was not statistically significant. The sK+ levels remained within the normal range from 3 to 6 months.ConclusionsThis real-world study demonstrated the efficacy and safety of finerenone treatment in IgAN patients during a 3-6 months follow-up period, providing clinical evidence to support its use in IgAN. However, further prospective research is needed to prove these findings.