Fenelidone (Keshenda) usage and dosage and individual adjustment methods for different patients

Finerenone is an oral non-steroidal mineral corticosteroid receptor antagonist, mainly used to treat patients with chronic kidney disease and type 2 diabetes. The standard recommended dose is taken orally once daily, usually 10 mg or 20 mg, depending on the patient's renal function and serum potassium levels. During the medication period, medication should be taken regularly to ensure stable blood concentration of the medication so as to achieve optimal efficacy.

In patients with normal or mildly impaired renal function, use is generally started at the recommended dose, and serum potassium and renal function indicators are regularly monitored. In the early stage of treatment, serum potassium and renal function are usually reviewed within 2–4 weeks. Based on the test results, it is judged whether the dose needs to be adjusted to prevent hyperkalemia and further deterioration of renal function.

For patients with moderately impaired renal function or at risk for hyperkalemia, consideration should be given to starting at a lower dose (e.g., 10mg once daily) and titrating to the target dose. During the treatment, if the blood potassium level rises or the kidney function drops significantly, the dosage should be reduced or suspended in time, and close monitoring should be carried out to ensure the safety of medication. Special attention also needs to be paid to dose adjustment and frequency of monitoring in patients taking diuretics or other drugs that affect serum potassium.

In addition, individualized adjustments are particularly important for elderly patients or patients with multiple underlying diseases. Clinically, it is recommended to select the dose based on the patient's weight, renal function, blood pressure and blood potassium level, and to follow up regularly. Through scientific monitoring and dose adjustment, fenelidone can reduce proteinuria and delay the decline of renal function while controlling the risk of adverse reactions within an acceptable range, achieving safe and effective individualized treatment.

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