Design and baseline characteristics of the Finerenone, in addition to standard of care, on the progression of kidney disease in patients with Non-Diabetic Chronic Kidney Disease (FIND-CKD) randomized trial.

Heerspink, Hiddo J L;Agarwal, Rajiv;Bakris, George L;Cherney, David Z I;Labriola, Laura;et.al.
(2025) Nephrology, Dialysis, Transplantation — Vol. 40, n° 2, p. 308-319 (2025)

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  • Heerspink, Hiddo J Lorcid-logo
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  • Agarwal, Rajiv
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  • Bakris, George L
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  • Cherney, David Z I
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  • Labriola, Lauraorcid-logoUCLouvain
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Abstract
Finerenone, a non-steroidal mineralocorticoid receptor antagonist, improved kidney, and cardiovascular outcomes in patients with CKD and T2D in two Phase 3 outcome trials. The FIND-CKD study investigates the effect of finerenone in adults with CKD without diabetes. FIND-CKD (NCT05047263 and EU CT 2023-506897-11-00) is a randomized, double-blind, placebo-controlled Phase 3 trial in patients with CKD of non-diabetic aetiology. Adults with a urinary albumin-creatinine ratio (UACR) of ≥ 200 to ≤3500 mg/g and eGFR ≥ 25 to <90 mL/min/1.73 m2 receiving a maximum tolerated dose of a renin-angiotensin-system (RAS) inhibitor were randomized 1:1 to once daily placebo or finerenone 10 or 20 mg depending on eGFR above or below 60 mL/min/1.73 m2. The primary efficacy outcome is total eGFR slope, defined as the mean annual rate of change in eGFR from baseline to Month 32. Secondary efficacy outcomes include a combined cardiorenal composite outcome comprising time to kidney failure, sustained ≥57% decrease in eGFR, hospitalization for heart failure, or cardiovascular death, as well as separate kidney and cardiovascular composite outcomes. Adverse events are recorded to assess tolerability and safety. Across 24 countries, 3231 patients were screened and 1584 were randomized to study treatment. The most common causes of CKD were chronic glomerulonephritis (57.0%) and hypertensive/ischaemic nephropathy (29.0%). Immunoglobulin A nephropathy was the most common glomerulonephritis (26.3% of the total population). At baseline, mean eGFR and median UACR were 46.7 mL/min/1.73 m2 and 818.9 mg/g, respectively. Diuretics were used by 282 participants (17.8%), statins by 851 (53.7%), and calcium channel blockers by 794 (50.1%). SGLT2 inhibitors were used in 16.9% of patients; these individuals had a similar mean eGFR (45.6 vs 46.8 mL/min/1.73 m2) and slightly higher median UACR (871.9 vs 808.3 mg/g) compared to those not using SGLT2 inhibitors at baseline. FIND-CKD is the first Phase 3 trial of finerenone in patients with CKD of non-diabetic aetiology.
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Heerspink, H. J. L., Agarwal, R., Bakris, G. L., Cherney, D. Z. I., Lam, C. S. P., Neuen, B. L., Sarafidis, P. A., Tuttle, K. R., Wanner, C., Brinker, M. D., Dizayee, S., Kolkhof, P., Schloemer, P., Vesterinen, P., & Perkovic, V. (2025). Design and baseline characteristics of the Finerenone, in addition to standard of care, on the progression of kidney disease in patients with Non-Diabetic Chronic Kidney Disease (FIND-CKD) randomized trial. Nephrology, Dialysis, Transplantation, 40(2), 308-319. https://doi.org/10.1093/ndt/gfae132 (Original work published 2025)