Watch for Finerenone, a New Med for Diabetic Kidney Disease

Finerenone (Kerendia) will be a new med for patients with chronic kidney disease (CKD) due to type 2 diabetes.

Finerenone is thought to limit inflammation and scarring in the kidneys and heart...which may slow kidney disease progression and reduce risk of cardiovascular events (heart attack, etc).

But anticipate that it will be a "niche" med.

Other steps...such as controlling blood pressure and blood sugar...should be taken first to help slow progression of kidney disease.

Plus some diabetes meds already help protect the kidneys and improve cardiovascular outcomes...such as empagliflozin (Jardiance) or liraglutide (Victoza). These also lower blood sugar...finerenone doesn't.

And finerenone costs about $20/day.

When taking med histories, expect patients getting finerenone to start with one 10 mg tablet by mouth once daily...and titrate up to 20 mg once daily.

Avoid look-alike/sound-alike mix-ups with finerenone. It can be mistaken for eplerenone...or finasteride.

Don't be surprised if finerenone isn't added to your formulary. It can be held during an admission...missing a few doses isn't likely to cause problems.

See our Kidneys: What Are They Good For? technician tutorial for more on preventing issues with kidney meds.

Key References

  • N Engl J Med. 2020 Dec 3;383(23):2219-2229
  • N Engl J Med. 2021 Aug 28. doi: 10.1056/NEJMoa2110956
  • Diabetes Care. 2021 Jan;44(Suppl 1):S151-S167
  • Medication pricing by Elsevier, accessed Oct 2021
Hospital Pharmacy Technician's Letter. November 2021, No. 371129

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