{"id":"4e64612704b9","type":"article","url":"https://hartvaat.nl/2026/07/31/finerenone-verhoogt-complete-nierremissie-bij-niet-diabetische-iga-nefropatie/","title":"Finerenone verhoogt complete nierremissie bij niet-diabetische IgA-nefropatie","title_en":"Efficacy and safety of finerenone in non-diabetic patients with IgA nephropathy.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["apotheker","internist"],"tags":[],"journal":"Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association","doi":"10.1093/ndt/gfag023","source_url":"https://doi.org/10.1093/ndt/gfag023","authors":["Ju'an Wang","Yuanmao Tu","Zige Chen","Zhaochen Guo","Jinglei Chen","Bian Wu","Zhihong Liu","Hao Bao"],"significance":6,"published":"2026-08-16","source_date":"2026-07-31","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/nierziekte/kdigo-richtlijn-ckd-2024/"],"congress":"","summary_en":"A retrospective cohort study of 382 patients with non-diabetic IgA nephropathy demonstrates that finerenone significantly improves complete renal remission rates (HR 2.58; p < 0.001) and reduces the risk of a ≥30% eGFR decline (HR 0.30; p = 0.036) compared to standard care alone. Potassium levels remained stable, and adding finerenone to an SGLT2 inhibitor yielded the highest remission rates. These findings support the nephroprotective role of finerenone in non-diabetic IgA nephropathy, particularly when combined with SGLT2 inhibitors.","created":"2026-08-09T01:30:28Z","updated":"2026-08-10T10:35:25Z","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":"Een retrospectieve analyse toont aan dat finerenone de kans op complete nierremissie (<0,5 g/dag eiwituitscheiding) aanzienlijk verhoogt bij patiënten met niet-diabetische IgA-nefropatie (HR 2,58; p < 0,001). Daarnaast werd het risico op een significante eGFR-daling (≥30%) met een factor drie gereduceerd (HR 0,30; p = 0,036), zonder toename van hyperkaliëmie. De combinatie met een SGLT2-remmer gaf een extra remissievoordeel. Deze bevindingen ondersteunen het gebruik van finerenone als veilig en effectief nierbeschermend middel in deze patiëntgroep, naast standaardtherapie.","abstract_original":"BACKGROUND: Finerenone has been proven to have cardiovascular and renal protective effects on chronic kidney disease associated with type 2 diabetes. However, the therapeutic effect of finerenone on IgA nephropathy (IgAN) without diabetes remains unclear. METHODS: A retrospective analysis was conducted on patients with primary IgAN who received standard treatment between September 2023 and June 2025. The patients were divided into the finerenone and control groups based on whether finerenone was used. The primary outcomes were the renal complete response (CR) rate (<0.5 g/day) and renal endpoint events [defined as a 30% reduction in estimated glomerular filtration rate (eGFR)], and the secondary outcomes were the degree of decrease in 24-h urine protein quantification, changes in eGFR and safety outcomes. RESULTS: A total of 382 patients were included (191 in the finerenone group and 191 in the control group). Finerenone significantly increased the CR rate compared with the control group [hazard ratio (HR) 2.58, 95% confidence interval (CI) 1.82-3.66, P < .001] and reduced the renal endpoint event (HR 0.30, 95% CI 0.07-0.91, P = .036). Finerenone combined with sodium-glucose cotransporter 2 inhibitors (SGLT2i) had a higher renal remission rate (with SGLT2i: HR 3.52, 95% CI 2.32-5.35; without SGLT2i: HR 1.54, 95% CI 0.75-3.19, Pinteraction = .032). The serum potassium levels in both groups remained consistent. CONCLUSION: Finerenone is safe and effective in treating IgAN patients without diabetes, and finerenone combined with SGLT2i has a higher CR rate."}