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非奈利酮在非糖尿病慢性肾脏病患者中的疗效与安全性:一项单中心、真实世界、回顾性研究

Efficacy and safety of finerenone in non-diabetic CKD patients: a single-center, real-world, retrospective study.

作者信息

Li Yu, Feng Jiaxing, Guo Xiaodan, Zhang Wusijie, Yang Ting, Guan Tianjun, Xu Bo

机构信息

Department of Nephrology, Zhongshan Hospital of Xiamen University, No. 201-209, Hubin South Road, Siming District, Xiamen, 361000, China.

Department of Gastroenterology, Zhongshan Hospital of Xiamen University, Xiamen, China.

出版信息

BMC Nephrol. 2025 Jul 1;26(1):323. doi: 10.1186/s12882-025-04241-w.

Abstract

BACKGROUND

Finerenone, a novel non-steroidal mineralocorticoid receptor antagonist, has shown promising efficacy and safety profiles in the management of chronic kidney disease (CKD) associated with type 2 diabetes mellitus (T2DM). However, evidence for its role in non-diabetic CKD patients require further investigation.

METHODS

This retrospective, real-world study involved non-diabetic CKD patients from April 2023 to June 2024. Participants received finerenone alongside standard CKD treatment. Primary clinical results included changes in the urinary albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), and serum potassium (sK) levels. The data were collected initially and during follow-ups at 1, 3, 6, and 12 months.

RESULTS

In total, 37 non-diabetic CKD patients were included in the population; 21 individuals (56.8%) were male, and the mean age was 48.84 ± 14.69 years. During the follow-up, there was a notable decrease in UACR, with a median reduction of 664.95 mg/g (IQR, 196.60-1226.70, P = 0.002). The baseline average eGFR was 70.80 ± 27.97 mL/min/1.73m, with no notable alterations observed during the follow-up (P > 0.05). In terms of safety analysis, the sK + levels were within the 3.5-5.5 mmol/L range, with no significant difference from the baseline (P > 0.05). No patients discontinued treatment or were hospitalized because of hyperkalemia.

CONCLUSION

Real-world practice indicates that finerenone is effective and safe for non-diabetic CKD patients, but further large-scale, prospective studies are needed to confirm these findings.

摘要

背景

非奈利酮是一种新型非甾体类盐皮质激素受体拮抗剂,在治疗2型糖尿病(T2DM)相关的慢性肾脏病(CKD)方面已显示出有前景的疗效和安全性。然而,其在非糖尿病CKD患者中的作用证据仍需进一步研究。

方法

这项回顾性的真实世界研究纳入了2023年4月至2024年6月的非糖尿病CKD患者。参与者在接受标准CKD治疗的同时服用非奈利酮。主要临床结果包括尿白蛋白与肌酐比值(UACR)、估算肾小球滤过率(eGFR)和血清钾(sK)水平的变化。数据在初始时以及随访1、3、6和12个月时收集。

结果

该人群共纳入37例非糖尿病CKD患者;21例(56.8%)为男性,平均年龄为48.84±14.69岁。随访期间,UACR显著下降,中位数降低664.95mg/g(IQR,196.60 - 1226.70,P = 0.002)。基线时平均eGFR为70.80±27.97mL/min/1.73m²,随访期间未观察到显著变化(P>0.05)。在安全性分析方面,sK⁺水平在3.5 - 5.5mmol/L范围内,与基线无显著差异(P>0.05)。没有患者因高钾血症而停药或住院。

结论

真实世界实践表明,非奈利酮对非糖尿病CKD患者有效且安全,但需要进一步的大规模前瞻性研究来证实这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7733/12218821/14086c59c06e/12882_2025_4241_Fig1_HTML.jpg

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