To investigate the clinical efficacy and safety of finerenone tablets combined with losartan potassium capsules in the treatment of patients with chronic kidney disease (stage 1-3) and non-diabetic immunoglobulin A (IgA) nephropathy.

Patients with chronic kidney disease (stage 1-3) and non-diabetic IgA nephropathy were divided into control group and treatment group according to different drug treatment plans. Control group was treated with losartan potassium capsules at an initial dose of 50 mg·time^-1, once a day, for 3 months. Treatment group was treated with finerenone tablets at an initial dose of 20 mg·time^-1, once a day, for 3 months, and combined with losartan potassium capsules, dose same as control group. The clinical efficacy and levels of renal function indexes, immunoglobulin indexes, complement indexes and inflammatory factors were compared between the two groups. The safety was evaluated.

A total of 96 cases were enrolled in this study. Among them, 47 cases were included in control group and 49 cases were included in treatment group. After treatment, the total effective rates in control group and treatment group were 82.98% (39 cases/47 cases) and 97.96% (48 cases/49 cases), and the treatment group was significantly higher (P<0.05). After treatment, glomerular filtration rates (eGFR) in control group and treatment group were (87.29±16.30) and (95.72±18.53) mL·min^-1·1.73 m^-2; 24 h urine protein levels were (0.69±0.14) and (0.48±0.10) g·24 h^-1; urinary albumin-to-creatinine ratios (UACR) were (32.96±6.38) and (26.57±5.49) mg·mmol^-1; blood urea nitrogen (BUN) levels were (12.68±2.24) and (11.15±2.17) mmol·L^-1; serum creatinine (SCr) levels were (122.39±24.73) and (108.45±21.94) μmol·L^-1; cystatin c (CysC) levels were (2.74±0.51) and (2.31±0.48) mmol·L^-1; IgA levels were (2.18±0.46) and (1.73±0.39) g·L^-1; complement (C) 3 levels were (0.95±0.18) and (1.14±0.22) g·L^-1; C4 levels were (1.27±0.25) and (1.53±0.29) g·L^-1; C1q levels were (0.19±0.05) and (0.23±0.06) g·L^-1; interleukin (IL)-2 levels were (16.83±4.32) and (12.18±3.75) ng·L^-1; IL-6 levels were (10.25±2.04) and (7.22±1.43) ng·L^-1; high-sensitivity C-reactive protein (hs-CRP) levels were (0.52±0.16) and (0.40±0.11) mg·L^-1. The differences in above indicators between treatment group and control group were statistically significant (all P<0.05). Adverse drug reactions in control group included dizziness, orthostatic hypotension, gastrointestinal reactions, skin rashes and hyperkalemia. Adverse drug reactions in treatment group included dizziness, orthostatic hypotension, gastrointestinal reactions and hyperkalemia. The total incidence rates of adverse reactions in treatment group and control group were 12.77% (6 cases/47 cases) and 14.29% (7 cases/49 cases), showing no statistically significant difference (P>0.05).

The clinical efficacy of fenelidone tablets combined with losartan potassium capsules in treatment of chronic kidney disease (stage 1-3) with non-diabetes IgA nephropathy is more significant than that of losartan potassium capsule alone. It can significantly increase eGFR, lower urine protein level, improve renal function and immune function and alleviate micro-inflammation, with good safety.