Reducing Albumin Improves Kidney and Heart Function

TOPLINE:

Reducing the urine albumin-to-creatinine ratio (UACR) significantly reduces kidney risk in people with type 2 diabetes, per new research in the Annals of Internal Medicine.

METHODOLOGY:

Post hoc retrospective analysis of two phase 3 double-blind trials of finerenone in people with type 2 diabetes and chronic kidney disease
Quantify the long-term health effects of reducing UACR within 4 months of taking finerenone by examining the records of 12,512 participants with an equal chance of receiving finerenone or placebo
Isolate the impact of UACR reduction on kidney function and cardiovascular function by tracking health indicators related to the kidneys and the heart in participants for up to 4 years

TAKEAWAY:

Over half of participants who received finerenone had reduced UACR by at least 30% from the baseline of 514 mg/g at the 4-month point after starting treatment, and the median UACR reduction in this group was 33%.
By 4 months, a little over a quarter of participants who received the placebo had reduced their UACR levels by at least 30%, and the median UACR reduction in this group was 2.6%.
A UACR reduction of at least 30% reduced kidney risk by 64%, as measured by reductions in kidney failure, sufficient glomerular filtration, and death from kidney disease.
A UACR reduction of at least 30% reduced cardiovascular risk by 26%, as measured by fewer incidences of cardiovascular death, nonfatal infarction or stroke, and hospitalization for heart failure.

IN PRACTICE:

"Achieving early UACR reduction can lead to tangible benefits for kidney and cardiovascular health," the authors note.

SOURCE :

The study was published in the Annals of Internal Medicine on December 4, 2023; the lead author is Rajiv Agarwal, MD, MS.

LIMITATIONS:

The study only pertains to finerenone, so the findings cannot be extrapolated to other drugs with different mechanisms of action.

DISCLOSURES:

Bayer AG Pharmaceuticals, which manufactures finerenone, was the primary funder of the study. The US National Institutes of Health and Veterans Administration also provided funding. Some study authors are full-time employees of Bayer AG. Many authors report consulting relationships with various pharmaceutical companies.

Credits:
Lead image: Bayer Corporation

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Cite this: Reducing Albumin Improves Kidney and Heart Function in People With Type 2 Diabetes - Medscape - Dec 04, 2023.

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