Impact of Finerenone on Kidney Function, Albuminuria, and Arterial Stiffness: Clinical Insights from a Pilot Six-Month Diabetic Kidney Disease Study

Background: Finerenone is a new therapeutic option for patients with diabetic kidney disease (DKD). This study examined its effects on albuminuria and arterial stiffness—key markers of cardiovascular and kidney health. Methods: We enrolled 32 DKD patients (71.9% male) treated with finerenone. Demographics, laboratory results, and arterial stiffness (SphygmoCor®, Atcor Medical) were recorded at baseline and after six months. Albuminuria was assessed using UACR from a random urine sample. GFR was estimated using the CKD-EPI 2009 creatinine equation. SPSS® v29.0 was used for statistical analysis. Results: Patients (mean age 65.6 ± 8.0 years) commonly had hypertension (100%), hyperlipidemia (93.8%), and heart failure (15.6%). Most used ACE inhibitors/ARBs (90.1%), SGLT-2 inhibitors (71.9%), and GLP-1 RAs (37.5%). Over six months, UACR dropped by 24.1% (p=0.103) and cfPWV by 6.7% (p=0.037). Changes in cfPWV correlated with UACR (r=0.453, p=0.010) and eGFR (r=0.447, p=0.012). Conclusion: Finerenone treatment led to early reductions in arterial stiffness and albuminuria. The significant correlations between vascular and renal markers suggest that improvements occur in parallel, reflecting finerenone’s dual mechanism of action. These results support finerenone as a promising therapeutic option for DKD.