{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T07:27:32Z","timestamp":1788852452188,"version":"build-2803163510"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"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. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetic kidney disease (DKD) is a critical complication of type 2 diabetes, often compounded by hyperuricemia, which may accelerate renal function decline. While finerenone, a nonsteroidal mineralocorticoid receptor antagonist (MRA), provides renal and cardiovascular benefits, its impact on uric acid (UA) metabolism in real-world DKD patients, particularly those with high baseline SUA, remains controversial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this retrospective, single-center study, we included 124 patients with type 2 DKD (baseline eGFR \u226560\u00a0mL\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      ) who initiated finerenone. Patients with recent gout or urate-lowering therapy were excluded. Changes in SUA, urinary albumin-to-creatinine ratio (UACR), and eGFR were assessed before and after 1\u20133 months of treatment. Statistical analyses employed linear mixed models for longitudinal data and multivariable regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Linear mixed model analysis showed finerenone treatment was associated with a significant reduction in SUA (adjusted mean difference: \u221247.9\u00a0\u03bcmol\/L, 95% CI: \u221263.5 to \u221232.3; p &amp;lt; 0.001). This reduction was substantially greater in patients with baseline hyperuricemia (\u221288.6\u00a0\u03bcmol\/L) than in those without (\u221216.6\u00a0\u03bcmol\/L; p for interaction = 0.003). UACR decreased by 39.4% (p &amp;lt; 0.001), while eGFR showed a small but significant decline (\u22122.7\u00a0mL\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      , p = 0.019). The SUA-lowering association was independent of concomitant SGLT2 inhibitor or GLP-1 receptor agonist use in multivariable analyses. Hyperkalemia (potassium \u22655.5\u00a0mmol\/L) occurred in 0.8% of patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this real-world cohort, finerenone use was associated with significant reductions in albuminuria and SUA, particularly among patients with hyperuricemia. These findings suggest a potential dual benefit in this high-risk subgroup and highlight the importance of baseline SUA in interpreting finerenone\u2019s metabolic effects. The observed SUA reduction warrants further prospective investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1782658","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T06:35:45Z","timestamp":1772433345000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Finerenone is associated with pronounced uric acid reduction in hyperuricemic diabetic kidney disease: a real-world analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Yanmei","family":"Lin","sequence":"first","affiliation":[{"name":"Xiamen Humanity Hospital","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianqing","family":"Tian","sequence":"additional","affiliation":[{"name":"Xiamen Humanity Hospital","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang","family":"Du","sequence":"additional","affiliation":[{"name":"Southern Business Group, ZoeSoft Company Limited","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Liu","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Xiamen University","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,2]]},"reference":[{"key":"B1","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."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1580645","DOI":"10.3389\/fmed.2025.1580645","article-title":"Finerenone in diabetic kidney disease: a new frontier for slowing disease progression","volume":"12","author":"Alhomoud","year":"2025","journal-title":"Front. Med. (Lausanne)"},{"key":"B3","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1016\/j.ccl.2024.12.003","article-title":"Role of glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide\/glucagon-like peptide-1 receptor agonists in management of cardiovascular-kidney-metabolic (CKM) conditions","volume":"43","author":"Alicic","year":"2025","journal-title":"Cardiol. Clin."},{"key":"B4","doi-asserted-by":"publisher","first-page":"S219","DOI":"10.2337\/dc25-S011","article-title":"11. 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Chinese guidelines for the diagnosis and treatment of hyperuricemia and gout","volume":"36","year":"2024","journal-title":"Chin. J. Endocrinol. Metab."},{"key":"B11","first-page":"423","article-title":"Mineralocorticoid receptors in diabetic nephropathy","volume":"19","author":"Epstein","year":"2008","journal-title":"J. Am. Soc. Nephrol."},{"key":"B12","first-page":"2345","article-title":"Efficacy and safety of finerenone combined with SGLT2 inhibitors in patients with diabetic kidney disease: a subgroup analysis of the FIDELITY study","volume":"26","year":"","journal-title":"Diabetes Obes. Metab."},{"key":"B13","first-page":"1023","article-title":"Safety and efficacy of finerenone in patients with diabetic kidney disease: a post hoc analysis of the FIDELITY study","volume":"35","year":"","journal-title":"J. Am. Soc. 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