Bayer's finerenone (Kerendia), a non-steroidal mineralocorticoid receptor antagonist, delivered statistically significant improvements in kidney function and reduced the risk of cardiorenal events in adults with non-diabetic chronic kidney disease (CKD), potentially positioning the drug for expansion beyond its currently approved diabetic kidney disease indication. The result matters because non-diabetic CKD accounts for the majority of the estimated 850 million people living with CKD globally, yet the approved treatment landscape has remained largely static.
The Phase III FIND-CKD trial is a randomized, placebo-controlled study enrolling more than 1,500 adults with non-diabetic CKD, including patients with hypertension and chronic glomerulonephritis, on background renin-angiotensin system blockade. The primary endpoint was the mean annual rate of change in eGFR from baseline to Month 32 — a surrogate the US FDA has recognized as a basis for approval in CKD. Bayer reported that finerenone achieved a statistically significant improvement in this eGFR slope measure versus placebo, and also reduced the risk of a composite kidney-cardiovascular outcome. The company also noted that finerenone reduced the risk of a composite kidney-cardiovascular outcome as a secondary finding. Safety was consistent with the established profile of finerenone, which includes hyperkalemia, hypotension, and hyponatremia. Bayer did not disclose the magnitude of the treatment difference or p-values, and said full results will be presented at an upcoming scientific conference.
Finerenone blocks the mineralocorticoid receptor, reducing aldosterone-driven inflammation and fibrosis in kidney and cardiac tissue beyond what RAS blockade alone achieves. The drug is already approved for CKD associated with type 2 diabetes and heart failure with preserved ejection fraction; FIND-CKD is the fifth consecutive Phase III trial in Bayer's FINEOVATE program to meet its primary endpoint. AstraZeneca's Farxiga (dapagliflozin), an SGLT2 inhibitor, holds CKD approval but with data concentrated in diabetic populations, while Novo Nordisk's Ozempic (semaglutide) gained a CKD indication in January 2025 specifically in type 2 diabetes. Bayer said it plans to submit the FIND-CKD data to the US FDA to seek an expanded indication for finerenone in non-diabetic CKD.
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