#1350 Finerenone in real-life clinical practice: first results from a pilot study

Abstract

Abstract Background and Aims Finerenone is a new drug for the treatment of patients with albuminuric diabetic kidney disease (DKD) that has protective cardiorenal effects, with hyperkalemia being a possible side effect. Our pilot study aimed to obtain real-life clinical data in patients with DKD treated with finerenone. Method So far, we have included 16 patients receiving finerenone due to albuminuric DKD (urine albumin/creatinine ratio - UACR > 3 g/mol in two random urine samples taken at least one week apart) (Fig. 1). Nine patients (56.3%) were prescribed 20 mg. Seven patients (43.7%) received 10 mg daily. The dose was then adjusted at follow-up visits according to guidelines. Arterial stiffness measurements were performed non-invasively (Sphygmocor Atcor Medical®, Australia). A 28-zone lung ultrasound (LUS) was performed, and the sum of B-lines was recorded (VscanTM GE HealthCare Technologies Inc.®). Bioimpedance was measured with BCM®, Fresenius Medical Care. SPSS version 29 was used for statistical analysis. Results 10 patients (62.5%) were male. The most common comorbidities were arterial hypertension (n=15, 93.8%), hyperlipidemia (n=15, 93.8%) and ischemic heart disease (n=4, 25%). Baseline data are shown in Table 1. Paired samples T-test showed a slight increase in serum potassium after introducing finerenone, without clinically significant hyperkalemia or renal damage. UACR decreased, but the difference was insignificant (Table 2). Patients had no change in prescribed medications during this time, and no side effects of finerenone were noted. Conclusion Finerenone has the potential to lower UACR with little risk of hyperkalemia or acute kidney injury. The effects of the drug on lung extracellular water, body composition and arterial stiffness will be prospectively investigated in our research.