Background & Objectives: Data on the efficacy and adverse effects of finerenone in patients with nondiabetic chronic kidney disease (CKD) are limited, particularly regarding ethnic diversity. This study aimed to evaluate the outcomes of finerenone in patients with nondiabetic CKD previously treated with standard therapies and investigate associated adverse effects, including hyperkalemia and hypotension. Methods: This is a retrospective exploratory study. It is a single-center study including patients with nondiabetic CKD who visited King Fahad Medical City in Riyadh, Saudi Arabia. The primary exposure was finerenone treatment, assessing its effects on albuminuria, kidney function, and blood pressure (BP), following prior use of renin–angiotensin–aldosterone system and sodium–glucose transport protein 2 inhibitors. The measured outcomes were the urine albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR). The UACR (primary endpoint) was calculated as the mean of two morning spot urine samples collected consecutively 1 day apart. During each 4-week treatment period, secondary endpoints included changes in UACR, as determined by a 24 h urine sample, BP, and eGFR. The Wilcoxon signed-rank test was used to compare changes in continuous variables before and after therapy initiation. Statistical significance was set at p < 0.05. Results: This study included 16 patients with nondiabetic CKD (median age, 38.5 years [range, 35–50 years]; 56.3% male). The baseline eGFR was 66 mL/min/1.73 m² (47–82.5), with a UACR of 90.0 mg/g (58.8–132.5). No hyperkalemia was observed (potassium level, 4 mmol/L [3.8–4.4]). However, significant reductions in systolic and diastolic BPs were observed. Albuminuria improved significantly: the UACR decreased from 90.0 to 39.3 mg/g (p = 0.04). No adverse events, including hyperkalemia or hypotension, were reported. Conclusions: Finerenone showed promise in reducing albuminuria and blood pressure among patients with nondiabetic chronic kidney disease, with no significant adverse effects reported. These findings suggest potential benefits for this patient population, warranting further investigation.

Introduction: The COVID-19 pandemic has profoundly affected medical education worldwide, leading to significant disruptions in healthcare systems. This study investigates the impact of the pandemic on the readiness for self-directed learning (SDL) among first-year, third-year, and fourth-year internal medicine residents in Saudi Arabia during the 2019–2020 academic year. Methods: A non-interventional cross-sectional study utilizing an online survey based on SDL concepts was conducted in Saudi Arabia in 2022-2023. Data were collected from 74 participants with ethical approval, and analysis involved statistical testing and questionnaire reliability evaluation. Results: Overall, participants exhibited high SDL readiness scores, indicating readiness for self-directed learning. Gender, Part 1 residency exam results, and effective knowledge sources did not significantly affect SDL preparedness. However, residents who dedicated eight or more hours weekly to reading demonstrated higher SDL readiness, emphasizing a strong commitment to self-directed learning. Choosing textbooks as a primary knowledge source was associated with increased SDL readiness scores. Although first-year residents showed higher SDL readiness ratings than senior fellows, this difference was not statistically significant. Notably, residents exhibited increased engagement in reading patient encounters. Conclusions: Despite pandemic challenges, Saudi Arabian internal medicine residents maintained high SDL readiness. The pandemic did not substantially alter SDL preparation concerning information sources, gender, or exam scores. Reading habits indicative of self-directed learning commitment positively influenced SDL preparedness. Larger sample sizes may be necessary to definitively assess SDL preparedness differences between first-year residents and the third- to fourth-year colleagues. These findings underscore the adaptability and resilience of medical students during global health crises, highlighting the importance of self-directed learning in medical education.