Efficacy and safety of finerenone in diabetic kidney disease: Latin American experience from FINDKDLATAM trial

doi:10.5527/wjn.v15.i1.115933

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World Journal of Nephrology

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World J Nephrol. Mar 25, 2026; 15(1): 115933
Published online Mar 25, 2026. doi: 10.5527/wjn.v15.i1.115933

Efficacy and safety of finerenone in diabetic kidney disease: Latin American experience from FINDKDLATAM trial

Rodrigo Daza Arnedo, Vicente Sánchez Polo, Jenniffer Benavides Garcia, Juan Felipe Gutiérrez, Enrique Ramos Clason, Daniel Domínguez, Giovany Mera Rebutti, Carlos Madrid Mancia, Rene Tabora López, Manuel Rocha Meza, Dany Tabora López, James J Muñoz Zambrano, Eduardo Lorca Herrera, Eliana Dina-Batlle, Michael Cieza Terrones, Thyago Proença de Moraes, Tomas Rodriguez Yánez, Washington Osorio, Alyi Arellano Cabeza, Jorge Rico-Fontalvo

Rodrigo Daza Arnedo, Vicente Sánchez Polo, Jenniffer Benavides Garcia, Daniel Domínguez, Manuel Rocha Meza, Eduardo Lorca Herrera, Eliana Dina-Batlle, Michael Cieza Terrones, Thyago Proença de Moraes, Jorge Rico-Fontalvo, Latin American Society of Nephrology and Hypertension, Panama City 0810, Panama

Rodrigo Daza Arnedo, Juan Felipe Gutiérrez, Jorge Rico-Fontalvo, Colombian Association of Nephrology and Arterial Hypertension, Bogota 111211, Colombia

Vicente Sánchez Polo, Faculty of Medicine, Department of Nephrology, University of San Carlos of Guatemala, Guatemala City 01012, Guatemala

Jenniffer Benavides Garcia, Department of Epidemiology, Universidad del Rosario, Bogota 111221, Colombia

Juan Felipe Gutiérrez, Department of Nephrology, Davita Kidney Care, Barranquilla 080020, Colombia

Enrique Ramos Clason, Faculty of Nursing, University of Cartagena, Health Services Administration Program, Bolivar 130010, Colombia

Enrique Ramos Clason, Coordinator of Postgraduate Medical and Surgical Research, Sinú University EBZ, GIBACUS Research Group, Bolivar 130014, Colombia.

Daniel Domínguez, Rene Tabora López, Dany Tabora López, Department of Nephrology, Del Valle Hospital, San Pedro Sula 21101, Cortés, Honduras

Giovany Mera Rebutti, Department of Nephrology, Dr. Abel Gilbert Pontón Hospital of Guayaquil, Ministry of Public Health, Guayaquil 090104, Guayas, Ecuador

Carlos Madrid Mancia, Department of Nephrology, Honduran Institute of Social Security, Transplant Committee of the Del Valle Hospital, San Pedro Sula 21101, Cortés, Honduras

Manuel Rocha Meza, Department of Nephrology, Bendaña Hospital National Autonomous University of Honduras, San Pedro Sula 21104, Cortés, Honduras

Manuel Rocha Meza, Internal Medicine, Dr. Mario Catarino Rivas Hospital, San Pedro Sula 21102, Cortés, Honduras

Manuel Rocha Meza, National Autonomous University of Honduras, San Pedro Sula 11101, Cortés, Honduras

Dany Tabora López, School of Medicine, Catholic University of Honduras, San Pedro Sula 11101, Cortés, Honduras

James J Muñoz Zambrano, Department of Nephrology, Rafael Rodríguez Zambrano Hospital, Manta 130802, Manabí, Ecuador

Eduardo Lorca Herrera, Faculty of Medicine, Department of Internal Medicine East, University of Chile, Providencia 7500998, Santiago Metropolitan Region, Chile

Eliana Dina-Batlle, Department of Nephrology, Metropolitan Hospital of Santiago, Santiago de Los Caballeros 51000, Santiago Province, Dominican Republic

Michael Cieza Terrones, Faculty of Science and Engineering, Department of Engineering, Peruana Cayetano Heredia University, Lima 15002, Peru

Thyago Proença de Moraes, Department of Nephrology, Pontifical Catholic University of Paraná, Curitiba 80215-901, Brazil

Tomas Rodriguez Yánez, Faculty of Medicine, Department of Internal Medicine, University of Cartagena, Cartagena 130015, Bolívar, Colombia

Washington Osorio, Department of Nephrology, Armed Forces Specialty Hospital Number 1, Quito 170150, Pichincha, Ecuador

Alyi Arellano Cabeza, Department of Internal Medicine, Hospital Universitario del Valle “Evaristo Garcia”, University of Valle, Cali 760043, Valle del Cauca, Colombia

Jorge Rico-Fontalvo, Faculty of Medicine, Department of Nephrology, Simón Bolívar University of Barranquilla, Barranquilla 080002, Atlántico, Colombia

Co-corresponding authors: Alyi Arellano Cabeza and Jorge Rico-Fontalvo.

Author contributions: Arnedo RD, Polo VS, Garcia JB, Gutiérrez JF, Clason ER, Domínguez D, Rebutti GM, Mancia CM, López RT, Meza MR, López DT, Muñoz Zambrano JJ, Herrera EL, Dina-Batlle E, Terrones MC, de Moraes TP, Yánez TR, Osorio W, Cabeza AA, and Rico-Fontalvo J made substantial contributions to the conception and design of the work; Arnedo RD, López RT, and Cabeza AA wrote main analysis, and interpretation of data; Terrones MC the creation of new software used in the work; Cabeza AA and Rico-Fontalvo J contributed equally to this manuscript and are co-corresponding authors. All authors reviewed the final manuscript.

Institutional review board statement: This retrospective study was approved by the Ethics Committee of Faculty of Medical Sciences at the University of San Carlos in Guatemala.

Informed consent statement: This study is a retrospective observational analysis of data collected from outpatient medical records in the nephrology department. Informed consent has been waived.

Conflict-of-interest statement: Arnedo RD states that he has received speaker’s fees for Astra Zeneca, Boehringer Ingelheim, Novo Nordisk, Bayer. He has served on Advisory Boards with Astra Zeneca, Boehringer Ingelheim, Bayer and Novo Nordisk. Polo VS has received speaker’s fees from Nipro, Baxter, Novartis, AstraZeneca, Bayer, Asofarma. Jenniffer Nataly Benavides Garcia works as a scientific liaison physician for Bayer SA Colombia in the cardiorenal area with a focus on diabetic kidney disease; however, her participation in this study was performed outside of work and did not conflict with her work at Bayer. Herrera EL has received speaker’s fees for AstraZeneca, Boehringer Ingelheim, Novo Nordisk, Novartis, Servier, Bayer, Merck, Axon Pharma and Lilly. He has served on Advisory Boards with Astra Zeneca. Dina-Batlle E has received speaker’s fees for Astra Zeneca, Novartis, Baxter, Sanofi. She has also received fees for clinical studies with Astellas and Aurinia. Fontalvo JR states that he has received speaker’s fees for Astra Zeneca, Boehringer Ingelheim, Novo Nordisk, Lilly, Sanofi, Novartis, AbbVie, Merck and Bayer. He has served on Advisory Boards with Astra Zeneca, Boehringer Ingelheim, Bayer and Novo Nordisk. The other authors report no conflict of interest.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: It is hereby stated that the data sets supporting the conclusions of this study are not publicly open. All data sets supporting the conclusions of this study are available upon request from the corresponding author.

Corresponding author: Jorge Rico-Fontalvo, PhD, Faculty of Medicine, Department of Nephrology, Simón Bolívar University of Barranquilla, 59^th Street No. 59-65, Barranquilla 080002, Atlántico, Colombia. jorgericof@yahoo.com

Received: October 29, 2025
Revised: December 17, 2025
Accepted: January 28, 2026
Published online: March 25, 2026
Processing time: 136 Days and 15 Hours

Abstract

BACKGROUND

Patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) face high renal and cardiovascular risks. Finerenone, a selective non-steroidal mineralocorticoid receptor antagonist, has demonstrated efficacy in reducing these risks in clinical trials. However, its real-world safety and effectiveness remain underexplored in local settings.

AIM

To evaluate the real-world safety and effectiveness of finerenone in patients with T2DM and CKD across seven Latin American countries.

METHODS

We conducted an observational, multicenter, retrospective cohort study based on real-world data in 347 patients with T2DM and CKD [urinary albumin-creatinine ratio (UACR) > 30 mg/g]. Patients received finerenone (10 mg or 20 mg daily), and clinical and laboratory parameters were evaluated at baseline and after six months of treatment.

RESULTS

At baseline, median values (interquartile range) were: Glycated hemoglobin A1c 7.6% (6.8%-8.1%); estimated glomerular filtration rate 39.0 mL/minute/1.73 m² (30.0-50.0); UACR 345 mg/g (189-760); systolic blood pressure 143 mmHg (130-160); diastolic blood pressure 79 mmHg (70-82); and serum potassium 4.4 mmol/L (4.1-4.7). After six months, significant reductions were observed: Glycated hemoglobin A1c to 7.0% (6.5%-7.9%); UACR to 81 mg/g (28-167); systolic blood pressure to 130 mmHg (120-140); and diastolic blood pressure to 73 mmHg (70-80). Serum potassium increased to 4.7 mmol/L (4.3-5.0), while estimated glomerular filtration rate remained stable at 41.6 mL/minute/1.73 m² (27.0-52.0).

CONCLUSION

In our cohort of patients with CKD associated with T2DM, finerenone proved to be an effective short-term therapy for reducing albuminuria, demonstrating very good tolerance and a low risk of hyperkalemia.

Keywords: Finerenone; Chronic kidney disease; Type 2 diabetes; Diabetic nephropathy; Albuminuria; Hyperkalemia

Core Tip: In a real-world observational study of 347 Latin American patients with type 2 diabetes mellitus and chronic kidney disease finerenone demonstrated significant short-term benefits. After six months, treatment led to major reductions in the urinary albumin-creatinine ratio and blood pressure. This efficacy was achieved with very good tolerance; the estimated glomerular filtration rate remained stable, and serum potassium increases were minimal, highlighting a low risk of hyperkalemia. This study provides crucial real-world evidence supporting finerenone’s safety and effectiveness.