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Not yet recruitingNCT07717697Updated Jul 21, 2026

Finerenone for the Treatment of Type 2 Diabetes-Related Kidney Disease: Efficacy Observation and Related Factor Analysis

An observational study in Type 2 Diabetes Mellitus and Diabetic Kidney Disease, sponsored by First Affiliated Hospital of Chongqing Medical University. Not yet recruiting. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-07-21.

Sponsored by First Affiliated Hospital of Chongqing Medical University · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
425
Ages
18 Years to 75 Years
Sex
All
01

Study summary

This is a single-center prospective observational clinical study conducted at the First Affiliated Hospital of Chongqing Medical University. A total of 425 patients aged 18-75 years with type 2 diabetes mellitus-related chronic kidney disease will be enrolled from February 2026 to January 2029. All participants will receive standard finerenone treatment in accordance with clinical guidelines with a 4-month follow-up period. Blood and urine samples will be collected at screening, baseline, 1 month, 2 months and 4 months after treatment initiation for routine biochemistry, aldosterone/renin testing, captopril suppression test and multi-omics analysis.

Participants will be categorized into benefit group, partial benefit group and non-benefit group based on the reduction rate of urine albumin-to-creatinine ratio (UACR) at Month 4. We will combine demographic data, laboratory indicators and multi-omics profiles to identify key biomarkers predicting finerenone response, and construct a predictive model to realize precise individualized therapy for diabetic kidney disease.

All study-related laboratory tests are free of charge for subjects. A priority consultation channel is available during follow-up, and free professional consultation on diabetic nephropathy will be provided. Serum potassium and renal function will be closely monitored to manage safety risks such as hyperkalemia. All personal data and biological samples are anonymized and stored in encrypted systems with strict confidentiality protection. Subjects may withdraw from the study voluntarily at any time without interference to their routine clinical care.

Read the detailed description

This single-center prospective observational cohort study will recruit 425 eligible adult patients aged 18-75 years diagnosed with type 2 diabetes mellitus associated chronic kidney disease (T2DM-CKD) from the Chongqing Diabetes Registry, endocrine wards and outpatient clinics of the First Affiliated Hospital of Chongqing Medical University between February 2026 and January 2029. All enrolled subjects will receive guideline-directed finerenone oral therapy for a 4-month observation period, with dose adjusted based on baseline eGFR and serum potassium levels per drug instructions.

Serial blood and urine biospecimens will be collected at screening, baseline, month 1, month 2 and month 4 visits. Collected samples will be tested for routine biochemistry, electrolytes, renal function, HbA1c, plasma renin and aldosterone; captopril suppression test and multi-omics profiling will also be performed at designated time points.

According to the percentage reduction of urine albumin-to-creatinine ratio (UACR) at month 4, participants will be stratified into three subgroups: benefit group (UACR reduction ≥30%), partial benefit group (10% ≤ UACR reduction \<30%), and non-benefit group (UACR reduction \<10% or elevated UACR). Primary objective is to identify core biomarkers associated with finerenone therapeutic response. Secondary outcomes include serial changes in eGFR, UACR, serum potassium, aldosterone and renin across all follow-up time points.

Sample size calculation was performed using R pmsampsize package, accounting for a 10% anticipated loss to follow-up to reach the target sample of 425 subjects. All statistical analyses will be conducted via R and Python with machine learning algorithms to develop and validate a predictive model for finerenone efficacy.

Safety monitoring including serum potassium and renal function assessment will be conducted at every visit. Subjects with hyperkalemia or progressive renal impairment will suspend finerenone per predefined criteria. All study-related laboratory examinations are provided free of charge to participants, with priority medical consultation service available throughout follow-up. All personal clinical data and biological samples are anonymized and stored under encrypted management to protect participant privacy. Subjects may withdraw consent at any time without impact on routine clinical treatment. Study findings will be summarized and published in peer-reviewed journals after data collection is fully completed.

02

Conditions studied

  • Type 2 Diabetes Mellitus
  • Diabetic Kidney Disease

Keywords

  • Finerenone
  • Type 2 diabetes mellitus
  • Diabetic kidney disease
  • Predictive model
  • Prospective observational study
03

In context

Diabetes Mellitus, Type 2

10,371 studies on the registry are indexed under Diabetes Mellitus, Type 2; 1,406 are open to participants now.

This study's planned enrollment of 425 is above the median of 300 across 1,741 observational studies indexed under Diabetes Mellitus, Type 2.

Browse Diabetes Mellitus, Type 2 studies →

Lead sponsor

First Affiliated Hospital of Chongqing Medical University is the lead sponsor of 95 studies on the registry; 42 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

This is a prospective observational cohort study enrolling patients with type 2 diabetes mellitus (T2DM) complicated with chronic kidney disease (CKD) receiving finerenone therapy. Subjects will be recruited from the Chongqing Diabetes Registry (CDR), endocrine outpatient and inpatient departments of the First Affiliated Hospital of Chongqing Medical University, with a recruitment window from February 2026 to January 2029. A total of 425 eligible participants are planned to be enrolled.

A target sample size of 425 participants is determined using the R pmsampsize package for predictive model development. Key input parameters: C-statistic of 0.80, 10 candidate predictive variables, expected finerenone responder proportion of 53.2% derived from FIDELIO-DKD and FIGARO-DKD trials. The minimum required sample size to satisfy model stability and calibration criteria is 383 participants. A 10% attrition rate is accounted for, leading to the final enrolment target of 425 patients.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Aged 18-75 years, male or female, with full capacity for independent conduct.
  • Confirmed type 2 diabetes-associated chronic kidney disease (CKD): Random urine albumin-to-creatinine ratio (UACR) of 100-5000 ug/mg Cr on two non-consecutive days; estimated (eGFR) calculated by the CKD-EPI formula >25 mL/min/1.73m²; Finerenone treatment is indicated per clinical guidelines.
  • All concomitant medications have remained stable for 3 months prior to screening, with no planned treatment adjustments throughout the trial. Stable medication is defined as dose adjustments not exceeding ±25% of the screening baseline dose.
  • If the glycemic regimen includes sodium-glucose cotransporter 2 inhibitors (SGLT-2i): The daily SGLT-2i dose remains constant for 3 months before screening, and no daily dose changes are planned during the entire trial. If the glycemic regimen excludes SGLT-2i: No SGLT-2i exposure within 4 weeks prior to screening, and no SGLT-2i initiation is planned throughout the trial.
  • If the glycemic regimen includes glucagon-like peptide-1 receptor agonists (GLP-1RA): The daily GLP-1RA dose remains constant for 3 months before screening, and no daily dose changes are planned during the entire trial. If the glycemic regimen excludes GLP-1RA: No GLP-1RA exposure within 4 weeks prior to screening, and no GLP-1RA initiation is planned throughout the trial.
  • Fully understands the entire trial procedure, voluntarily participates in the study and signs the form.

Exclusion criteria

Exclusion Criteria:

  • Diagnosed or suspected type 1 diabetes, special type diabetes or secondary diabetes.
  • Poor glycemic control with (HbA1c) >9.0%.
  • Average seated office blood pressure measured over 3 visits with systolic blood pressure >160 mmHg and/or diastolic blood pressure >100 mmHg.
  • Serum potassium >5.0 mmol/L without potassium supplementation.
  • Diagnosed or suspected chronic kidney disease unrelated to diabetic nephropathy.
  • Complicated with liver cirrhosis or moderate-to-severe liver impairment.
  • Patients with secondary aldosteronism and primary aldosteronism who have surgery plans within six months.
  • Confirmed Addison's disease.
  • Complicated with uncontrolled diseases.
  • Complicated with active malignant tumors.
  • Presence or suspicion of depression, bipolar disorder, suicidal tendency, schizophrenia or other severe mental illnesses; or lack of mental capacity or language barrier, unable to fully understand the trial protocol or unwilling to cooperate with study site staff.
  • Complicated with other uncontrolled chronic diseases.
  • Use of serum potassium-elevating agents (e.g., amiloride, triamterene) or other mineralocorticoid receptor antagonists (MRAs, e.g., spironolactone, eplerenone) within 4 weeks prior to screening.
  • Use of strong inhibitors (itraconazole, ketoconazole, ritonavir, nelfinavir, cobicistat, clarithromycin, telithromycin, nefazodone) or CYP3A4 inducers (carbamazepine, phenytoin, erythromycin, fluvoxamine) within 2 weeks prior to screening.
  • Pregnant or breastfeeding women.
Terms in these criteria, in plain language(5)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

HbA1c

A blood test of average blood sugar over the past two to three months, given as a percentage or in mmol/mol. 6.5% (48 mmol/mol) or more is the usual threshold for diabetes, normally confirmed by a second test.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

CYP3A (CYP3A4) inhibitors and inducers

CYP3A is a group of enzymes, mainly CYP3A4, in the liver and gut that break down many medicines. Some medicines, supplements and foods (grapefruit, St John’s wort) slow them down or speed them up, which changes how much of a study drug stays in the body.

Studies list them so they can be avoided or switched; bring a list of everything you take, including supplements.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
425 participants (estimated)
Patient registry
No
Biospecimen retention
Samples with dna

Groups and cohorts

  • Finerenone Treatment Cohort

    All enrolled participants with type 2 diabetes mellitus-related chronic kidney disease receive guideline-standard oral finerenone therapy for a 4-month observation period. The finerenone dose is adjusted according to each subject's baseline eGFR and serum potassium level following the official drug instructions. Concomitant hypoglycemic, antihypertensive and lipid-lowering medications remain stable during the whole study period as required by inclusion criteria. Serial blood and urine biospecimens are collected at multiple follow-up time points for routine biochemical tests, captopril suppression test and multi-omics detection. After 4 months of treatment, subjects will be divided into three analytic subgroups based on UACR reduction rate to explore predictive biomarkers of finerenone efficacy.

    Drug: Finerenone

Interventions

  • Oral finerenone administered once daily for 4 months. Dosage is individualized based on baseline estimated glomerular filtration rate (eGFR) and serum potassium per drug labeling. Subjects maintain stable background hypoglycemic, antihypertensive and lipid-lowering therapies throughout the observational period. No additional study-specific drugs or experimental procedures are applied; only routine clinical finerenone treatment is observed with serial blood and urine sample collection for multi-omics and biomarker analysis.

06

What researchers measure

Primary outcomes

  1. Key biomarkers associated with therapeutic response to finerenone

    Identify core multi-omics, biochemical and clinical biomarkers that predict whether patients with type 2 diabetes-related chronic kidney disease can achieve renal benefit from finerenone treatment.

    Time frame: 4 months after finerenone initiation

Secondary outcomes

  1. Percentage change in urine albumin-to-creatinine ratio (UACR) from baseline to Month 4

    Stratify participants into benefit (UACR reduction ≥30%), partial benefit (10% ≤ UACR reduction \<30%), non-benefit (reduction \<10% or increased UACR) based on UACR decline at Month 4.

    Time frame: Baseline, Month 4

  2. Serial change in estimated glomerular filtration rate (eGFR)

    Dynamic variation of eGFR at each follow-up visit compared with baseline.

    Time frame: Baseline, Month 1, Month 2, Month 4

  3. Serial change in serum potassium

    Continuous monitoring of serum potassium to assess the risk of hyperkalemia during finerenone treatment.

    Time frame: Baseline, Month 1, Month 2, Month 4

  4. Changes in plasma aldosterone and renin at Month 4

    Difference of plasma aldosterone and renin levels between baseline and Month 4 after finerenone intervention.

    Time frame: Baseline, Month 4

07

Study locations

No study locations are listed for this record.

08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Jul 2026; primary completion for Jan 2029, 30 months later.

Of 432 non-industry observational studies under Diabetes Mellitus, Type 2, half reached primary completion within 35 months of starting (the median), counting those still running; a quarter within 17 and three quarters within 96. This study's planned 30 months is below that.

Counting every sponsor, half of 602 studies reached it within 32 months; a quarter within 17 and three quarters within 62.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 16, 2026
First posted
Jul 21, 2026
StartEst.
Jul 30, 2026
Primary completionEst.
Jan 30, 2029
CompletionEst.
Jan 30, 2029
Last update
Jul 21, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 21, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT07717697
Lead sponsor
First Affiliated Hospital of Chongqing Medical University
Responsible party
Zhihong Wang (Chief Physician, Professor, First Affiliated Hospital of Chongqing Medical University) — Principal investigator
First posted
Jul 21, 2026
Start date
Jul 30, 2026 (estimated)
Primary completion
Jan 30, 2029 (estimated)
Completion
Jan 30, 2029 (estimated)
Last update
Jul 21, 2026

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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