{"id":"1894c4dc5a2b","type":"article","url":"https://hartvaat.nl/2026/01/01/effect-van-finerenon-op-de-nierfunctie-bij-diabetische-nefropathie-type-2/","title":"Effect van finerenon op de nierfunctie bij diabetische nefropathie type 2","title_en":"Effect of finerenone on renal function in patients with type 2 diabetic nephropathy: a retrospective cohort study.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["apotheker","huisarts","internist"],"tags":["acuut-hartfalen","anemie-ckd","bloeddrukbehandeling","canagliflozine","cardiorenal-behandelstrategie","chronische-nierziekte","diabetes-en-hart","diabetes-type-2","fidelio-dkd","fidelity","figaro-dkd","finerenon-hartfalen-nierziekte","perifeer-vaatlijden","ras-remmers","sacubitril-valsartan","soul-trial"],"journal":"Frontiers in endocrinology","doi":"10.3389/fendo.2026.1753126","source_url":"https://doi.org/10.3389/fendo.2026.1753126","authors":["Xu-Ying Liu","Ya-Min Zhao","Ya-Guang Zhang","Yi Liu","Bo-Ya Wang","Zhen-Zhen Hao","Man-Hui Hu"],"significance":4,"published":"2026-01-01","source_date":"2026-01-01","image":"https://hartvaat.nl/global/img/f9ed94fb64aa.webp","kennis":["https://hartvaat.nl/kennis/nierziekte/contrastmiddel-en-nierfunctie/","https://hartvaat.nl/kennis/nierziekte/diabetische-nefropathie/"],"congress":"","summary_en":"A retrospective cohort study evaluated finerenone added to ACE inhibitor or ARB therapy in type 2 diabetic nephropathy. Finerenone slowed renal function decline and reduced albuminuria with a favourable safety profile.","created":"2026-07-03T10:25:50Z","updated":"2026-07-03T13:25:12Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Deze retrospectieve cohortstudie onderzocht het toevoegen van finerenon aan ACE-remmer- of ARB-therapie bij patiënten met diabetische nefropathie. Finerenon vertraagde de achteruitgang van de nierfunctie en verminderde albuminurie, met een gunstig veiligheidsprofiel. De studie identificeerde ook voorspellers voor klinisch relevante nierverslechtering.","abstract_original":"BACKGROUND: Diabetic nephropathy (DN) remains a major cause of chronic kidney disease despite optimized renin-angiotensin system blockade. This study aimed to evaluate the efficacy and safety of adding finerenone to angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker (ACEI/ARB) therapy and to identify predictors of clinically meaningful renal deterioration in patients with DN. METHODS: This retrospective cohort study enrolled adult patients (18-80 years) with a confirmed diagnosis of DN according to American Diabetes Association and Kidney Disease: Improving Global Outcomes criteria, who had complete baseline and follow-up data. Patients with type 1 diabetes, non-diabetic kidney disease, severe hepatic dysfunction, advanced heart failure, recent acute cardiovascular events, or baseline hyperkalemia were excluded. A total of 240 patients treated between January 2019 and December 2024 were included. Patients receiving ACEI/ARB monotherapy (control group, n = 124) were compared with those receiving ACEI/ARB plus finerenone (observation group, n = 116). Renal and metabolic parameters were assessed at baseline and after 24 weeks. Between-group comparisons were performed using appropriate parametric or nonparametric tests, and multivariable logistic regression analysis was conducted to identify independent predictors of a ≥15% estimated glomerular filtration rate (eGFR) decline. RESULTS: After 24 weeks, patients receiving finerenone showed significantly lower Scr (128.3 ± 27.6 μmol/L vs. 140.8 ± 35.1 μmol/L, P = 0.002), higher eGFR (56.8 ± 11.4 vs. 50.1 ± 12.3 mL/min/1.73 m², P < 0.001), and lower UACR (301.4 ± 142.7 vs. 398.7 ± 176.8 mg/g, P < 0.001) than controls. Finerenone treatment independently protected against renal deterioration (adjusted odds ratio [aOR] = 0.473, 95% CI: 0.253-0.883, P = 0.019), while longer diabetes duration, lower baseline eGFR, and higher UACR predicted ≥15% eGFR decline. Both regimens were well tolerated, with no increase in severe hyperkalemia or serious adverse events. CONCLUSIONS: Adding finerenone to ACEI/ARB therapy improved renal parameters over 24 weeks and was independently associated with reduced risk of clinically meaningful eGFR decline without excess serious adverse events."}