Abstract
INTRODUCTION: Patients with diabetic kidney disease (DKD) have an increased risk of not only renal, but also cardiovascular events. Finerenone is a novel, non-steroidal antagonist of the mineralocorticoid receptor that reduces albuminuria, protects kidney function, and improves cardiovascular outcomes. MATERIALS AND METHODS: Our aim was to evaluate the impact of finerenone on arterial stiffness parameters following 6 months of treatment. Additionally, we aimed to assess its effects on kidney function, potassium level, albuminuria (urinary albumin-to-creatinine ratio (UACR)), and hydration status, as measured by lung ultrasound (B-lines) and bioimpedance spectroscopy (BIS). Statistical analysis was conducted using SPSS. RESULTS: We included 25 patients, with the average age 63.8 ± 8.4 years (range 43 - 73 years). Serum potassium increased after 1 month of treatment (4.5 ± 0.4 vs. 4.3 ± 0.4 mmol/L at baseline, p = 0.017) and remained stable afterwards. Kidney function remained stable, and UACR decreased slightly, with the lowest value at 3 months (67.0 ± 97.7 vs. 82.6 ± 116.6 g/mol at baseline, p = 0.054). Carotid-femoral pulse wave velocity decreased from 12.0 ± 3.1 m/s at baseline to 10.9 ± 3.1 m/s (p = 0.015). No effect on blood pressure or the degree of BIS overhydration was noted. However, we found a decrease in the number of B-lines after 6 months of treatment (4.9 ± 5.5 vs. 7.4 ± 8.4 at baseline, p = 0.021). CONCLUSION: Our findings indicate that after 6 months of treatment, finerenone led to a decrease in central arterial stiffness and interstitial lung water. Kidney function remained stable, no clinically significant hyperkalemia occurred.