# Finerenone vertraagt nierfunctieverlies en verlaagt eiwituitscheiding bij niet-diabetische CKD — FIND-CKD & meta-analyse

*geplaatst 2026-11-14 · Nierziekte · International urology and nephrology · doi 10.1007/s11255-026-05442-4 · https://hartvaat.nl/2026/11/05/finerenone-vertraagt-nierfunctieverlies-en-verlaagt-eiwituitscheiding-bij-niet-d/*

Een systematische review en meta-analyse toont aan dat finerenone de eGFR-daling bij patiënten met niet-diabetische chronische nierziekte (CKD) significant vertraagt (verschil in helling +0,70 mL/min/1,73m²/jaar; P < 0,001) en de kans op een ≥ 30% daling van de eiwituitscheiding met een factor vier verhoogt (OR 3,99). Hoewel hyperkaliëmie vaker voorkwam (17,0% versus 13,3%), was het veiligheidsprofiel over het algemeen gunstig. Deze bevindingen ondersteunen het gebruik van finerenone als nierbeschermende therapie bij niet-diabetische CKD, met de nadruk op regelmatige kaliumcontrole.

## English: Efficacy and safety of finerenone in non-diabetic chronic kidney disease: a systematic review and meta-analysis.

A systematic review and meta-analysis demonstrates that finerenone significantly slows eGFR decline in patients with non-diabetic chronic kidney disease (difference in slope +0.70 mL/min/1.73m²/year; P < 0.001) and roughly quadruples the odds of achieving a ≥ 30% reduction in proteinuria (OR 3.99). Hyperkalaemia was more frequent with finerenone (17.0% vs 13.3%), but overall adverse events and discontinuation rates remained low. These findings support finerenone as a kidney-protective option for non-diabetic CKD, highlighting the need for routine potassium monitoring.

## Abstract (original, from the publication)

PURPOSE: Finerenone, a non-steroidal mineralocorticoid receptor antagonist (nsMRA), reduces composite kidney, and cardiovascular endpoints in diabetic CKD. Its efficacy and safety across non-diabetic CKD aetiologies remain uncharacterised in prior meta-analyses. METHODS: Four databases were searched to May 2026. RCTs and observational studies enrolling adults with non-diabetic CKD receiving finerenone were eligible. Two streams were used: Stream A (single-arm) and Stream B (comparative, finerenone vs. controls). The primary outcomes were eGFR slope/12-month change and proteinuria reduction; safety outcomes were hyperkalaemia, hypotension, adverse events, and discontinuation. Random-effects models (Hartung-Knapp), ROB-2, Newcastle-Ottawa Scale, GRADE, and TSA were applied. RESULTS: Nine studies (N = 2020) met eligibility, including two RCTs (the placebo-controlled FIND-CKD trial (n = 1584) and an open-label crossover pilot), alongside seven observational studies. Finerenone significantly slowed eGFR decline in the RCT (slope difference +0.70 mL/min/1.73m2/year, 95%CI 0.30-1.10; P < 0.001) and increased odds of a ≥ 30% proteinuria response roughly four-fold (pooled OR 3.99, 95% CI 1.91-8.30; P = 0.027). Two propensity-matched IgAN cohorts showed a 76.8% reduction in proteinuria versus controls (95% CI -81.1% to -72.6%; I2 = 0%). In single-arm analysis, 28.9% achieved a ≥ 50% proteinuria reduction. Hyperkalaemia was more frequent with finerenone (17.0% vs 13.3%; OR 1.34, 95% CI 1.02-1.76), though any adverse event did not differ (OR 1.15, 95% CI 0.67-1.99); pooled hyperkalaemia was 1.6%, hypotension 0.5%, discontinuation 0/258. CONCLUSIONS: In non-diabetic CKD, finerenone slows eGFR decline, supported by high-certainty evidence from FIND-CKD, and reduces proteinuria, with a modest rise in hyperkalaemia. These data support finerenone as a kidney-protective, proteinuria-lowering therapy, underscoring the need for potassium monitoring, and further trials.

Auteurs: Abbas Khan, F N U Sawaira, Gauhar Ullah, Hafiz Abad Mahmood, Muhammad Hassan Ameer, Abdullah Abbas, Irtaza Hassan, Mahnoor Javed, Nimra Ehsan, Nour Aldin T Ahmed, David Escalante

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Bron: International urology and nephrology, https://doi.org/10.1007/s11255-026-05442-4. Bijgewerkt 2026-11-07T02:59:36Z. 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.