Efficacy and Safety of Finerenone in Patients With Primary Membranous Nephropathy

Inclusion Criteria: * 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. * eGFR ≥60 (CKD-EPI). * Postmenopausal or postoperatively infertile status or on medical contraception (considering the potential risk of thromboembolism in patients with kidney disease) in women. * Voluntary signing of informed consent. Exclusion Criteria: * 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. * Treatment with any other study drug within the last month. * Females with a positive pregnancy screening test, lactating or planning to become pregnant in the next 24 months. Female or male patients unwilling to use contraceptive methods throughout the study. * A history of mental illness. * Laboratory tests meeting the following criteria: 1. Hemoglobin levels \<80 g/L; 2. Platelet count \<80×109/L; 3. Neutrophil count \<1.0×109/L; 4. Aspartate aminotransferase (AST) or amino aminotransferase (ALT) \>2.5 times the upper limit of normal, except in relation to the primary disease. * Very high-risk cases (life-threatening nephrotic syndrome or unexplained rapid deterioration of renal function). * Unsuitability for inclusion in the trial as judged by the investigator.