Finerenone is a nonsteroidal, selective mineralocorticoid receptor antagonist assigned to patients with chronic kidney disease (CKD) and type-2 diabetes. However, the effects of prolonged use of finerenone are not known. This study aims to evaluate chronic kidney disease outcomes in patients with CKD and type-2 diabetes.

This double-blind, randomized trial included a total of 5,734 patients with CKD and type-2 diabetes. The patients were randomly assigned in a 1:1 ratio to receive finerenone (n=2,833 or placebo (n=2,841). The primary outcome of the study was kidney failure, a sustained decrease of eGFR (at least 40%), or death due to renal causes.

During a median follow-up of 2.6 years, a primary event was reported in 504 patients in the finerenone group and 600 patients in the placebo group. A key secondary outcome, including death from cardiovascular causes, nonfatal stroke, nonfatal myocardial infarction, or hospitalization for heart failure, occurred in 367 patients in the finerenone group and 420 patients in the placebo group. However, the incidence of hyperkalemia-related discontinuation was higher in the finerenone group.

The research concluded that treatment with finerenone was associated with a lower risk of CKD progression and cardiovascular events when compared with placebo in patients with CKD and type-2 diabetes.

Ref: https://www.nejm.org/doi/full/10.1056/NEJMoa2025845