This is a prospective, randomized, multicenter, controlled trial. One hundred sixteen patients with primary membranous nephropathy (PMN) will be randomly divided into the intervention and control groups. The intervention group will be administered maximum tolerable dose of ACEI/ARB and finerenone 20 mg QD. Control patients will be administered maximum tolerable dose of ACEI/ARB. The primary endpoint is the relative change in urinary protein content from baseline to 6 months.
Adults (age≥18,and ≤75) with primary MN.
Administration of the maximum tolerable dose of ACEI/ARB for ≥4 weeks.
BP ≤140/90 mmHg.
Urine protein content of 1.0-5.0 g/d.
Type 1 or type 2 diabetes. Patients with a recent history of steroid-induced diabetes were eligible with renal biopsy showing no evidence of secondary diabetic nephropathy within 6 months before the screening period.
Patients with secondary membranous nephropathy (e.g., due to hepatitis B and C, systemic lupus erythematosus, drug therapy, malignant tumors and other secondary causes).
Uncontrolled arterial hypertension.
Treatment with glucocorticoids, immunosuppressants and/or biological agents in the past 6 months.