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All Journal Jurnal Ilmu Kedokteran (Journal of Medical Science) Jurnal Online Mahasiswa (JOM) Bidang Kedokteran Majalah Kedokteran Andalas Indonesian Journal of Kidney and Hypertension Nusantara Science and Technology Proceedings Unri Conference Series: Community Engagement Jurnal EduHealth
Ligat Pribadi Sembiring
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Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Dentistry Economics, Econometrics & Finance Engineering Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Public Health Veterinary

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Finerenone in Diabetic-Kidney Disease, Renal and Cardiovascular Outcome: A Meta-Analysis of Independent Trial Registries Gracia, Felicita; Simanjuntak, Arya Marganda; Amanda, Samira; Mustika, Linda Ida; Juwanto, Juwanto; Sembiring, Ligat Pribadi; Karimi, Jazil; Harahap, Sari; Rosmaliana, Rosmaliana
Indonesian Journal of Kidney and Hypertension Vol 2 No 3 (2025): Volume 2 No. 3, December 2025
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v2i3.224

Abstract

Background: Diabetic kidney disease (DKD) remains a frequent complication of type 2 diabetes, which significantly increases cardiovascular risk. Despite existing treatments, a substantial risk of disease progression still remains, leading to further exploration in Finerenone, a selective nonsteroidal mineralocorticoid receptor antagonist. Objective: This meta-analysis evaluates finerenone’s effects on the improvement of cardiorenal outcomes in DKD. Methods: A Systematic Review and Meta-Analysis (PROSPERO CRD420251122382) followed PRISMA guidelines. PubMed, ScienceDirect, and Epistemonikos utilized and used keywords “Finerenone AND Diabetes AND Chronic Kidney Disease AND Outcomes.” RCTs comparing finerenone to placebo in DKD, reporting renal or cardiovascular outcomes, were included. Data extraction covered study characteristics and outcomes. RevMan 5.4 analyzed data using a random-effects model. Risk of bias (RoB2) and certainty of evidence (GRADE-PRO) were assessed. Results: Three RCTs (19,027 participants) were included for renal outcomes, and two RCTs (13,026 participants) for cardiovascular outcomes. Finerenone significantly reduced the odds of sustained eGFR decline ≥40% (OR 0.83, p=0.0003) and≥57% (OR 0.86, p=0.0001), as well as the major composite kidney outcome (OR 0.76, p<0.0001). ESKD odds reduction (21%) was not statistically significant. For cardiovascular outcomes, finerenone significantly reduced hospitalization for heart failure (OR 0.78, p=0.0001). Trends towards reduced cardiovascular death (OR 0.88, p=0.09) were noted. Studies had low bias risk, and most outcomes showed moderate evidence certainty. Conclusions: Finerenone is associated with significant renoprotection and significantly reduces heart failure hospitalizations in DKD. Finerenone as an effective nonsteroidal mineralocorticoid receptor antagonist for comprehensive management, improving cardiorenal outcomes in this high-risk group.
New Guideline for Chronic Kidney Disease 2024, What Primary Care Can Do About It?: A Narrative Review Simanjuntak, Arya Marganda; Heryadi, Samantha Yaffa; Sembiring, Ligat Pribadi
Indonesian Journal of Kidney and Hypertension Vol 3 No 1 (2026): Vol 3 No 1 (2026): Volume 3 No. 1, April 2026
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v3i1.232

Abstract

Chronic Kidney Disease (CKD) presents an urgent global public health crisis, affecting over 850 million people worldwide, with low-income nations like Indonesia facing a high burden of undiagnosed cases due to limited awareness and a deficient primary care system. This paper serves as a vital, practical response to the novelty of the KDIGO 2024 Clinical Practice Guideline update, which incorporates a decade of new evidence, including the ethical imperative to eliminate the race coefficient from eGFR equations and the introduction of consensus-based "Practice Points." Key findings from this review highlight that CKD diagnosis is not solely reliant on Glomerular Filtration Rate (GFR), but also on persistent markers of kidney damage such as albuminuria and urine sediment abnormalities. The 2024 updates strongly recommend the race-free CKD-EPI 2021 equation for routine screening, the use of estimated GFR based on creatinine and cystatin C (eGFRcr-cys) for superior accuracy, and the strong recommendation for Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2i) in Type 2 Diabetes patients with CKD. Additionally, the guidelines introduce actionable risk prediction thresholds for nephrology referral, alongside practical advice like "sick day rules" for primary care. This review addresses the critical research gap concerning the primary care sector's capacity and capability by synthesizing the KDIGO 2024 updates. It concludes that primary care, as the frontline in health services, must rapidly adopt these standards to enhance early screening, improve patient risk stratification, and facilitate timely, informed referrals to advanced care, thereby mitigating disease progression and improving patient outcomes globally.
Co-Authors Ade Novita Reslina, Ade Novita Agung Ramadhan Alfarez, Muhammad Rendi Amanda, Samira Carlo Manuel Perangin-angin Dani Rosdiana Definov Tacsa Meta Eka Bebasari Erika Yusticia Handayani Faradilla Monita, Faradilla Ferry Anggriawan Garneta, Shafira Garnetta, Shafira Gracia, Felicita Harahap, Sari Heryadi, Samantha Yaffa Indriani, Haidatul Jazil Karimi Juwanto Juwanto Mustika, Linda Ida Rahmat Azhari Kemal Rita Endriani Rizqina Putri Rosmaliana, Rosmaliana Simanjuntak, Arya Marganda Tamaulina Br Sembiring