Health & Medicine

New Drug Could Help Millions Keep Their Kidneys Working Longer

A large international trial found that finerenone significantly slows kidney function decline in patients with chronic kidney disease who do not have diabetes — a group with historically limited treatment options.

• The FIND-CKD study enrolled 1,584 adults with chronic kidney disease and followed them for over three years, finding that finerenone slowed the decline in kidney function significantly.
• Patients taking finerenone had a 23% lower risk of serious complications including kidney failure, hospitalization for heart failure, and cardiovascular death.
• The drug reduced urinary protein — an early warning sign of kidney damage — by a substantial margin, even in patients already receiving standard care.

Chronic kidney disease affects roughly one in seven adults worldwide, and its prevalence is rising as populations age. The condition gradually impairs the kidneys' ability to filter waste from the blood, and it can progress silently for years before symptoms appear. When it reaches advanced stages, patients require dialysis or a kidney transplant to survive. For decades, the standard treatment has been ACE inhibitors or angiotensin receptor blockers, which help control blood pressure and reduce protein leakage into urine. But many patients continue to decline despite optimal therapy, particularly those whose kidney disease is not caused by diabetes.

Now, a major international clinical trial called FIND-CKD offers hope for this group. Published in the New England Journal of Medicine, the study found that the drug finerenone can significantly slow the loss of kidney function in people with chronic kidney disease who do not have diabetes.

The study, led by clinical pharmacologist Hiddo Lambers Heerspink of the University Medical Center Groningen, enrolled 1,584 adults with chronic kidney disease and followed them for an average of just over three years. Every participant had impaired kidney function along with elevated levels of protein in the urine — a key warning sign that kidney damage may continue to worsen. Participants were randomly assigned to receive either a daily dose of finerenone or a placebo, with both groups continuing standard treatment with ACE inhibitors or angiotensin receptor blockers.

The results were clear. Researchers measured how kidney function changed over a 2.5-year follow-up period using estimated glomerular filtration rate (eGFR), which reflects how effectively the kidneys filter waste. Patients treated with finerenone experienced a statistically significant slowing in the decline of eGFR compared with those who received the placebo. "In the finerenone group, 13.9% experienced such a complication, compared to 16.9% in the placebo group," Lambers Heerspink said. "That amounts to a reduction in risk of approximately 23%."

Another important benefit was a substantial reduction in urinary protein, an early indicator of kidney damage. The drug targets a specific pathway involved in inflammation and fibrosis — the same kind of scarring process that drives kidney disease progression. By blocking this pathway, finerenone appears to slow the underlying disease process rather than simply managing symptoms.

For the millions of people living with chronic kidney disease who do not have diabetes, the findings represent a meaningful expansion of treatment options. The drug is already approved for use in diabetic kidney disease, and this study suggests its benefits extend to a broader patient population. If adopted into clinical practice, finerenone could help delay the need for dialysis or kidney transplantation for many patients, improving quality of life and reducing health care costs.