{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T16:35:42Z","timestamp":1793205342039,"version":"4.5.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"Background<\/jats:title>Type 2 diabetes (T2D) is a considerable and growing burden in the Chinese population, and affected adults are at high risk of developing chronic kidney disease (CKD). This subgroup analysis of the FIGARO-DKD trial explored the cardiovascular and kidney benefits of finerenone in Chinese patients with CKD and T2D on optimized renin\u2013angiotensin system blockade.<\/jats:p><\/jats:sec>Methods<\/jats:title>Patients with urine albumin-to-creatinine ratio (UACR) \u226530\u2013&lt;300 mg\/g and estimated glomerular filtration rate (eGFR) \u226525\u2013\u226490 mL\/min\/1.73 m2<\/jats:sup>, or UACR \u2265300\u2013\u22645000 mg\/g and eGFR \u226560 mL\/min\/1.73 m2<\/jats:sup>, were randomized to finerenone or placebo. The primary cardiovascular composite outcome was time to cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, or hospitalization for heart failure. The secondary kidney composite outcome was time to kidney failure, sustained eGFR decline \u226540% from baseline, or kidney-related death.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 325 Chinese patients were included. Finerenone resulted in a numerical decrease in the risk of the cardiovascular composite outcome (hazard ratio 0.91; 95% confidence interval 0.50\u20131.67) and a significantly reduced risk of the key secondary kidney outcome (hazard ratio 0.48; 95% confidence interval 0.29\u20130.79; p<\/jats:italic> = 0.0029). The incidence of investigator-reported hyperkalemia was high across both treatment arms. Nevertheless, the incidence of hyperkalemia leading to hospitalization and treatment discontinuation was low across treatment arms.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Finerenone significantly reduced the composite kidney outcome, showed a trend to reduce cardiovascular outcomes, and demonstrated an acceptable safety profile in Chinese patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1568438","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T04:12:00Z","timestamp":1745986320000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of finerenone on chronic kidney disease progression in Chinese patients with type 2 diabetes: a FIGARO-DKD subgroup analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Ping","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongguang","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhua","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiping","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxiu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaohui","family":"Mo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiping","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meike","family":"Brinker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Roberts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalong","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"key":"B1","unstructured":"IDF Diabetes Atlas. \n \n \n \n 2021"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.892860","article-title":"The burden of diabetes-related chronic kidney disease in China from 1990 to 2019","volume":"13","author":"Pan","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1382","DOI":"10.1186\/s12889-022-13759-9","article-title":"Prevalence, awareness and control of type 2 diabetes mellitus and risk factors in Chinese elderly population","volume":"22","author":"Yan","year":"2022","journal-title":"BMC Public Health"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-0442","article-title":"Globalization of diabetes: the role of diet, lifestyle, and genes","volume":"34","author":"Hu","year":"2011","journal-title":"Diabetes Care"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-018-1145-5","article-title":"Asian Americans & chronic kidney disease in a nationally representative cohort","volume":"20","author":"Kataoka-Yahiro","year":"2019","journal-title":"BMC Nephrol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1111\/dom.14251","article-title":"Use of sodium-glucose co-transporter-2 inhibitors in Asian patients with type 2 diabetes and kidney disease: an Asian perspective and expert recommendations","volume":"23","author":"Khoo","year":"2021","journal-title":"Diabetes Obes Metab"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5000377","article-title":"Prevalence and risk factors for microalbuminuria in a referred cohort of type II diabetic patients: a global perspective","volume":"69","author":"Parving","year":"2006","journal-title":"Kidney Int"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1133290","article-title":"The concordance and discordance of diabetic kidney disease and retinopathy in patients with type 2 diabetes mellitus: a cross-sectional study of 26,809 patients from 5 primary hospitals in China","volume":"14","author":"Liu","year":"2023","journal-title":"Front Endocrinol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1038\/nrneph.2015.173","article-title":"Changing epidemiology of type 2 diabetes mellitus and associated chronic kidney disease","volume":"12","author":"Thomas","year":"2016","journal-title":"Nat Rev Nephrol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.120.050686","article-title":"Cardiovascular disease in chronic kidney disease: pathophysiological insights and therapeutic options","volume":"143","author":"Jankowski","year":"2021","journal-title":"Circulation"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.xkme.2023.100604","article-title":"CKD progression risk and subsequent cause of death: a population-based cohort study","volume":"5","author":"Rai","year":"2023","journal-title":"Kidney Med"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(13)60595-4","article-title":"Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention","volume":"382","author":"Gansevoort","year":"2013","journal-title":"Lancet"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1159\/000513782","article-title":"Cardiovascular and renal outcomes in patients with type-2 diabetes and chronic kidney disease identified in a United States administrative claims database: a population cohort study","volume":"145","author":"Folkerts","year":"2021","journal-title":"Nephron"},{"key":"B14","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.amjmed.2015.08.025","article-title":"Practical approach to detection and management of chronic kidney disease for the primary care clinician","volume":"129","author":"Vassalotti","year":"2016","journal-title":"Am J Med"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-038401","article-title":"Associations between multimorbidity and adverse clinical outcomes in patients with chronic kidney disease: a systematic review and meta-analysis","volume":"10","author":"Sullivan","year":"2020","journal-title":"BMJ Open"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2020.113513","article-title":"The effects of ageing population on health expenditure and economic growth in China: a Bayesian-VAR approach","volume":"265","author":"Lopreite","year":"2020","journal-title":"Soc Sci Med"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.02.030","article-title":"Mineralocorticoid receptor antagonists and kidney diseases: pathophysiological basis","volume":"96","author":"Barrera-Chimal","year":"2019","journal-title":"Kidney Int"},{"key":"B18","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1146\/annurev-pharmtox-010814-124302","article-title":"Mineralocorticoids in the heart and vasculature: new insights for old hormones","volume":"55","author":"Lother","year":"2015","journal-title":"Ann Rev Pharmacol Toxicol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa736","article-title":"Steroidal and non-steroidal mineralocorticoid receptor antagonists in cardiorenal medicine","volume":"42","author":"Agarwal","year":"2021","journal-title":"Eur Heart J"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2110956","article-title":"Cardiovascular events with finerenone in kidney disease and type 2 diabetes","volume":"385","author":"Pitt","year":"2021","journal-title":"N Engl J Med"},{"key":"B21","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1186\/s12882-020-01852-3","article-title":"Ethnic minority disparities in progression and mortality of pre-dialysis chronic kidney disease: a systematic scoping review","volume":"21","author":"Hounkpatin","year":"2020","journal-title":"BMC Nephrol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfac157","article-title":"Kidney outcomes with finerenone: an analysis from the FIGARO-DKD study","volume":"38","author":"Ruilope","year":"2023","journal-title":"Nephrol Dial Transplant"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2014.08.017","article-title":"GFR decline as an alternative end point to kidney failure in clinical trials: a meta-analysis of treatment effects from 37 randomized trials","volume":"64","author":"Inker","year":"2014","journal-title":"Am J Kidney Dis"},{"key":"B24","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1053\/j.ajkd.2019.06.009","article-title":"Change in albuminuria and GFR as end points for clinical trials in early stages of CKD: a scientific workshop sponsored by the National Kidney Foundation in collaboration with the US Food and Drug Administration and European Medicines Agency","volume":"75","author":"Levey","year":"2020","journal-title":"Am J Kidney Dis"},{"key":"B25","article-title":"Macroalbuminuria and microalbuminuria: do both predict renal and cardiovascular events with similar strength","volume":"20","author":"de Jong","year":"2007","journal-title":"J Nephrol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.2337\/dci22-0027","article-title":"Diabetes management in chronic kidney disease: a consensus report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO)","volume":"45","author":"de Boer","year":"2022","journal-title":"Diabetes Care"},{"key":"B27","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1016\/j.xkme.2021.04.018","article-title":"Retinopathy and risk of kidney disease in persons with diabetes","volume":"3","author":"Hong","year":"2021","journal-title":"Kidney Med"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-S011","article-title":"11. Chronic kidney disease and risk management: standards of care in diabetes\u20142023","volume":"46","year":"2023","journal-title":"Diabetes Care"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.2337\/dci23-0030","article-title":"Diabetic nephropathy: update on pillars of therapy slowing progression","volume":"46","author":"Naaman","year":"2023","journal-title":"Diabetes Care"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2021070942","article-title":"Hyperkalemia risk with finerenone: results from the FIDELIO-DKD trial","volume":"33","author":"Agarwal","year":"2022","journal-title":"J Am Soc Nephrol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab777","article-title":"Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis","volume":"43","author":"Agarwal","year":"2022","journal-title":"Eur Heart J"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1111\/nep.14281","article-title":"Consensus statement on the management of hyperkalaemia \u2013 an Asia-Pacific perspective","volume":"29","author":"Yap","year":"2024","journal-title":"Nephrol (Carlton)"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2025845","article-title":"Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes","volume":"383","author":"Bakris","year":"2020","journal-title":"N Engl J Med"},{"key":"B34","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1159\/000531997","article-title":"Finerenone in patients with chronic kidney disease and type 2 diabetes: the FIDELIO-DKD subgroup from China","volume":"9","author":"Zhang","year":"2023","journal-title":"Kidney Dis"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.828403","article-title":"Cardiorenal risk profiles among data-driven type 2 diabetes sub-phenotypes: a post-hoc analysis of the China Health and Nutrition Survey","volume":"13","author":"Gao","year":"2022","journal-title":"Front Endocrinol (Lausanne)"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1568438\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T04:12:06Z","timestamp":1745986326000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1568438\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,30]]},"references-count":35,"alternative-id":["10.3389\/fendo.2025.1568438"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1568438","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,30]]},"article-number":"1568438"}}