Finerenone continues its evidence journey, now tackling non-diabetic, proteinuric CKD.
The Filtrate
Joel Topf @kidney_boy
Swapnil Hiremath @hswapnil.medsky.social
Anna Gaddy @annagaddy.bsky.social
Natalie Freidin Program director at Medical University of South Carolina
Special Guests
Brendon “Brendo” Neuen The first Five-Time guest on Freely Filtered. Nephrologist and Director, Kidney Trials, Royal North Shore Hospital. Associate Professor of Medicine at the George Institute
Editing
Natalie Freidin
The Kidney Connection written and performed by Timothy Yau
Show Notes
Donate to the fall pledge drive: https://www.nephjc.com/news/2026/9/8/nephjc-fall-pledge-drive
Come to the ASN NephJC Night in Denver the Kidney Week: https://www.nephjc.com/news/2026/9/13/the-2026-nephjc-night
FIND-CKD: Finerenone in Persons with Chronic Kidney Disease without Diabetes NEJM | NephJC
2-year GFR data on sibeprelimab
Incidence of ESRD in the US due to IgAN (estimate using USRDS data)
Heinz 57 wikipedia
Randomised placebo-controlled trial of effect of ramipril on decline in glomerular filtration rate and risk of terminal renal failure in proteinuric, non-diabetic nephropathy. The Lancet 1997. The REIN trial for people with nephrotic range proteinuria (>3 grams/day)
Renoprotective properties of ACE-inhibition in non-diabetic nephropathies with non-nephrotic proteinuria, The Lancet 1999 REIN Stratum 1 for sub-nephrotic range proteinuria (1-3 grams/day)
Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes FIDELIO in NephJC | NEJM
Benefits of aldosterone receptor antagonism in chronic kidney disease BARACK-D RCT PubMed
We discussed the run in. Importantly the run in for FIDELIO and FIGRO did not give finerenone. This is sometimes done to assure that participants in a trial will tolerate the study drug but this will over inflate data on tolerability. See NephJC’s discussion on run ins here: https://www.nephjc.com/news/run-in-period
Sean Barbour on Freely Filtered talking about the TESTING Trial
FINALITY-HF A randomized, double-blind, placebo-controlled pragmatic study to evaluate FINerenone on clinicAL effIcacy and safeTY in patients with Heart Failure and reduced ejection fraction who are intolerant of or not eligible for treatment with steroidal mineralocorticoid receptor antagonists. ClinicalTrials.gov
Boehringer provides update on EASi-KIDNEY trial 😢
Pooled finerenone data INFINITY Pooled Analysis
Tubular Secretion
Swapnil The Will of the Many by James Islington (Amazon)
Anna The Art Thief: A True Story of Love, Crime, and a Dangerous Obsession by Michael Finkel (Amazon)
Brendo John Mayer Electric Guitar (PRS Guitar)
Natalie Great Big Beautiful Life by Emily Henry (Amazon)
Joel Come to the NephJC party at Kidney Week!