{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T06:20:20Z","timestamp":1783059620081,"version":"3.54.6"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"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. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>After baseline immunosuppression and renin-angiotensin system inhibitor (RASi) treatment for lupus nephritis (LN), the persistence of residual proteinuria is a core risk factor for poor renal prognosis, which is closely related to continuous progression of renal inflammation and fibrosis and long-term elevated risk of end-stage renal disease. Finerenone is a highly selective non-steroidal mineralocorticoid receptor antagonist (MRA) that has been proven to reduce proteinuria and exert renal protective effects in diabetic nephropathy. However, its association with proteinuria changes and safety profile in residual proteinuria of LN remain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective case series enrolled 10 patients with clinically diagnosed LN who had residual proteinuria (24-h urine protein quantification \u22650.5\u202fg) despite \u22656\u202fmonths of standard treatment. Finerenone 10\u202fmg once daily was added to the original treatment, and patients were followed for 24\u202fweeks. The primary endpoint was change in 24-h urine protein quantification; secondary endpoints included serum albumin, estimated glomerular filtration rate (eGFR), and safety parameters. Data were presented as median (interquartile range, P25, P75). Repeated measurements were compared using the Friedman test with Bonferroni correction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, 12\u202fweeks, and 24\u202fweeks, 24-h urine protein quantification was 1.595\u202fg (1.52, 2.37), 1.06\u202fg (0.79, 1.63), and 0.315\u202fg (0.27, 0.35), respectively (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f18.20,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Serum albumin showed an increase from 3.68\u202fg\/ dL (3,680\u202fmg\/dL, 3,530\u20133,770\u202fmg\/dL) to 4.075\u202fg\/dL (4,075\u202fmg\/dL, 3,910\u20134,200\u202fmg\/dL). eGFR remained stable during follow-up, changing from 108.3\u202fmL\u00b7min\n                      <jats:sup>\u22121<\/jats:sup>\n                      \u00b7(1.73\u202fm\n                      <jats:sup>2<\/jats:sup>\n                      )\n                      <jats:sup>\u22121<\/jats:sup>\n                      (88.3, 112.3) to 113.95\u202fmL\u00b7min\n                      <jats:sup>\u22121<\/jats:sup>\n                      \u00b7(1.73\u202fm\n                      <jats:sup>2<\/jats:sup>\n                      )\n                      <jats:sup>\u22121<\/jats:sup>\n                      (96.6, 119.7). All patients completed the 24-week follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this case series, add-on low-dose finerenone (10\u202fmg\/d) was associated with a significant reduction in residual proteinuria, an increase in serum albumin, stable renal function, and favorable safety in LN patients. These observational findings require validation in controlled trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1852929","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T05:39:34Z","timestamp":1783057174000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Finerenone as adjunctive therapy for residual proteinuria in lupus nephritis: a case series of 10 patients"],"prefix":"10.3389","volume":"13","author":[{"given":"Rui","family":"Gao","sequence":"first","affiliation":[{"name":"School of Clinical Medicine, Shandong Second Medical University","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianan","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, Shandong Second Medical University","place":["Weifang, Shandong, China"]},{"name":"Weifang People's Hospital, Shandong Second Medical University","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, Shandong Second Medical University","place":["Weifang, Shandong, China"]},{"name":"Weifang People's Hospital, Shandong Second Medical University","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Li","sequence":"additional","affiliation":[{"name":"Weifang People's Hospital, Shandong Second Medical University","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"9995","DOI":"10.3390\/ijms22189995","article-title":"Mineralocorticoid receptor antagonists-use in chronic kidney disease","volume":"22","author":"Baran","year":"2021","journal-title":"Int J Mol Sci"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1097\/FJC.0000000000000091","article-title":"Finerenone, a novel selective nonsteroidal mineralocorticoid receptor antagonist protects from rat cardiorenal injury","volume":"64","author":"Kolkhof","year":"2014","journal-title":"J Cardiovasc Pharmacol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"3694","DOI":"10.1016\/j.ekir.2025.07.039","article-title":"Finerenone as a nonsteroidal mineralocorticoid receptor antagonist for lupus nephritis","volume":"10","author":"Sun","year":"2025","journal-title":"Kidney Int Rep"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1093\/ajh\/hpac124","article-title":"The nonsteroidal mineralocorticoid-receptor-antagonist finerenone in cardiorenal medicine: a state-of-the-art review of the literature","volume":"36","author":"Georgianos","year":"2023","journal-title":"Am J Hypertens"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1499","DOI":"10.2215\/CJN.0000000000000540","article-title":"Potential role of mineralocorticoid receptor antagonists in nondiabetic chronic kidney disease and glomerular disease","volume":"19","author":"Zachariah","year":"2024","journal-title":"Clin J Am Soc Nephrol"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2604625","article-title":"Finerenone in persons with chronic kidney disease without diabetes","author":"Heerspink","year":"2026","journal-title":"N Engl J Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"152","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 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Nephrol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"474","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"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1852929\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T05:39:35Z","timestamp":1783057175000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1852929\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,3]]},"references-count":11,"alternative-id":["10.3389\/fmed.2026.1852929"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1852929","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,3]]},"article-number":"1852929"}}