FINERENONE was related to a considerably greater danger of incident nephrolithiasis than spironolactone, sodium-glucose cotransporter-2 inhibitors (SGLT2i), and angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, in line with a comparative real-world proof research. The findings recommend that nephrolithiasis could warrant consideration when assessing remedy with finerenone in sufferers with power kidney illness (CKD).
The retrospective cohort research used information from the TriNetX US Collaborative Community protecting June 2021 to June 2024. Researchers included grownup sufferers initiating finerenone and in contrast them with propensity-score matched cohorts beginning spironolactone, SGLT2i, or angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (ACEi/ARB). The first end result was a brand new analysis of nephrolithiasis occurring 4 to 16 months after remedy initiation.
Greater Nephrolithiasis Danger Throughout Comparators
After matching, finerenone was related to the next incidence of nephrolithiasis throughout all three comparator teams. In contrast with spironolactone, the hazard ratio (HR) was: 1.328; 95% confidence interval (CI): 1.065 t0 1.657. In contrast with SGLT2i, the HR was: 1.483; 95% CI: 1.118 to 1.967. Towards ACEi/ARB, the HR was: 1.495; 95% CI: 1.145 to 1.953.
These findings corresponded to relative will increase in nephrolithiasis danger of 32.8%, 48.3%, and 49.5%, respectively. The affiliation remained constant throughout subgroups that included sufferers with CKD, sort 2 diabetes mellitus, and hypertension.
Implications for Scientific Apply
The info additionally highlighted a possible interplay with SGLT2i remedy. Amongst sufferers with sort 2 diabetes mellitus who have been already receiving an SGLT2i, including finerenone was considerably related to higher stone danger than SGLT2i monotherapy.
The authors concluded that finerenone was related to the next incidence of new-onset nephrolithiasis and recommended that it might affect the potential stone-protective results of SGLT2i. For clinicians, these findings present comparative real-world proof that will inform consideration of nephrolithiasis danger when finerenone is used alongside different CKD pharmacological therapies.
Reference
Chen YH et al. Danger of nephrolithiasis with finerenone versus different power kidney illness drugs: a comparative real-world proof research. Sci Rep. 2026;DOI:1038/s41598-026-65475-8.
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