The effect of finerenone on arterial stiffness in patients with diabetic kidney disease: A pilot study.

INTRODUCTION

Patients with diabetic kidney disease (DKD) have an increased risk of not only renal, but also cardiovascular events. Finerenone is a novel, non-steroidal antagonist of the mineralocorticoid receptor that reduces albuminuria, protects kidney function, and improves cardiovascular outcomes.

MATERIALS AND

METHODS

Our aim was to evaluate the impact of finerenone on arterial stiffness parameters following 6 months of treatment. Additionally, we aimed to assess its effects on kidney function, potassium level, albuminuria (urinary albumin-to-creatinine ratio (UACR)), and hydration status, as measured by lung ultrasound (B-lines) and bioimpedance spectroscopy (BIS). Statistical analysis was conducted using SPSS.

RESULTS

We included 25 patients, with the average age 63.8 ± 8.4 years (range 43 - 73 years). Serum potassium increased after 1 month of treatment (4.5 ± 0.4 vs. 4.3 ± 0.4 mmol/L at baseline, p = 0.017) and remained stable afterwards. Kidney function remained stable, and UACR decreased slightly, with the lowest value at 3 months (67.0 ± 97.7 vs. 82.6 ± 116.6 g/mol at baseline, p = 0.054). Carotid-femoral pulse wave velocity decreased from 12.0 ± 3.1 m/s at baseline to 10.9 ± 3.1 m/s (p = 0.015). No effect on blood pressure or the degree of BIS overhydration was noted. However, we found a decrease in the number of B-lines after 6 months of treatment (4.9 ± 5.5 vs. 7.4 ± 8.4 at baseline, p = 0.021).

CONCLUSION

Our findings indicate that after 6 months of treatment, finerenone led to a decrease in central arterial stiffness and interstitial lung water. Kidney function remained stable, no clinically significant hyperkalemia occurred.