{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:50:41Z","timestamp":1786373441268,"version":"build-2736575974"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004326","name":"Bayer AG","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004326","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2026,3]]},"abstract":"\n Key Points<\/jats:title>\n \n \n \n Finerenone reduced albuminuria versus placebo in patients with a history of nephrectomy, similar to those without a history of nephrectomy.<\/jats:p>\n <\/jats:list-item>\n \n Incidences of treatment-emergent adverse events or serious adverse events were generally similar in patients with and without history of nephrectomy.<\/jats:p>\n <\/jats:list-item>\n \n Finerenone may delay kidney disease progression in patients with CKD and type 2 diabetes, irrespective of nephrectomy status.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n \n Finerenone significantly reduced the risk of cardiovascular and kidney outcomes in patients with CKD and type 2 diabetes (T2D) in FIDELITY, a prespecified pooled analysis of two phase 3 trials. This\n post hoc<\/jats:italic>\n FIDELITY analysis examined the efficacy and safety of finerenone in patients with CKD, T2D, and a history of nephrectomy.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Patients in FIDELITY were randomized to receive finerenone or placebo and were on optimized renin\u2013angiotensin system inhibition. We identified nephrectomy status using patients' medical history and assessed CKD progression in patients by nephrectomy status at baseline by modeling change in urine albumin-to-creatinine ratio from baseline to months 4\u201324. Safety outcomes included treatment-emergent adverse events and incident hyperkalemia.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 12,990 patients, 108 had a history of nephrectomy at baseline; 101 of 108 had radical nephrectomy, 55 received finerenone, and 53 received placebo. Baseline mean eGFR were numerically lower in patients with a history of nephrectomy (48\u00b117 ml\/min per 1.73 m\n 2<\/jats:sup>\n ) than in patients without (58\u00b122 ml\/min per 1.73 m\n 2<\/jats:sup>\n ). For patients with a history of nephrectomy, those who received finerenone had a greater urine albumin-to-creatinine ratio reduction at 4 months versus those who received placebo (least-squares mean ratio to baseline, 0.65 versus 1.09; least-squares mean treatment ratio, 0.60; 95% confidence interval, 0.48 to 0.76;\n P<\/jats:italic>\n < 0.001). This reduction was maintained for 2 years. Treatment-emergent adverse events were similar in patients with and without a history of nephrectomy. Among patients with a history of nephrectomy, treatment-emergent hyperkalemia occurred in 7% and 6% of finerenone and placebo groups, respectively.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Finerenone reduced albuminuria compared with placebo and demonstrated a safety profile consistent with the overall FIDELITY population in patients with and without a history of nephrectomy at baseline. Finerenone may delay CKD progression and associated morbidity in patients with CKD and T2D, irrespective of nephrectomy status.<\/jats:p>\n <\/jats:sec>\n \n Clinical Trial registry name and registration number:<\/jats:title>\n FIDELIO-DKD (NCT02540993); FIGARO-DKD (NCT02545049).<\/jats:p>\n <\/jats:sec>","DOI":"10.2215\/cjn.0000000932","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T17:00:16Z","timestamp":1768410016000},"page":"414-424","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Finerenone in People with CKD, Type 2 Diabetes, and History of Nephrectomy"],"prefix":"10.2215","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0669-6055","authenticated-orcid":false,"given":"Jair","family":"Munoz Mendoza","sequence":"first","affiliation":[{"name":"Katz Family Division of Nephrology and Hypertension, Department of Medicine, Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miller School of Medicine, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8820-5702","authenticated-orcid":false,"given":"Matthew R.","family":"Weir","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan D.","family":"Anker","sequence":"additional","affiliation":[{"name":"Department of Cardiology (CVK) of German Heart Center Charit\u00e9, German Centre for Cardiovascular Research (DZHK) Partner Site Berlin, Charit\u00e9 Universit\u00e4tsmedizin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5640-0332","authenticated-orcid":false,"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, School of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1531-4294","authenticated-orcid":false,"given":"Peter","family":"Rossing","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen, Copenhagen, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Ahlers","sequence":"additional","affiliation":[{"name":"Statistics and Data Insights, Bayer AG, Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1560-9535","authenticated-orcid":false,"given":"Meike","family":"Brinker","sequence":"additional","affiliation":[{"name":"Cardiology and Nephrology Clinical Development, Bayer AG, Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel T.","family":"Fatoba","sequence":"additional","affiliation":[{"name":"Bayer US, LLC, Medical Affairs, Whippany, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Horvat-Broecker","sequence":"additional","affiliation":[{"name":"Bayer AG, Medical Affairs and Pharmacovigilance, Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"Rohwedder","sequence":"additional","affiliation":[{"name":"Cardio-Renal Medical Affairs Department, Bayer AG, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1313-7773","authenticated-orcid":false,"given":"Alessia","family":"Fornoni","sequence":"additional","affiliation":[{"name":"Katz Family Division of Nephrology and Hypertension, Department of Medicine, Peggy and Harold Katz Family Drug Discovery Center, University of Miami, 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