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July 4, 2026Kidney Research and Clinical PracticeOpen Access

Finerenone and ns-MRAs reduce residual kidney and CV risk in DKD.

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Population

Patients with type 2 diabetes and chronic kidney disease, particularly those with persistent albuminuria…

Design

Review

Key result

Nonsteroidal mineralocorticoid receptor antagonists, particularly finerenone, reduce residual kidney and cardiovascular risk in patients with diabetic kidney disease and are recommended as a core component of guideline-directed therapy.

Authors

HJHye Yun JeongELEun Young Lee

Discussion

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Overview

Prompts finerenone integration into T2D-CKD care to reduce cardiorenal events; extends RCT data into guideline-directed practice.

Key Points

  • To evaluate the role of nonsteroidal mineralocorticoid receptor antagonists in managing diabetic kidney disease and their clinical implications.
  • Summary of clinical evidence and pathophysiological rationale for ns-MRAs in diabetic kidney disease.
  • Discussion of combination strategies with sodium-glucose cotransporter 2 inhibitors.
  • Examination of safety considerations and guideline recommendations for ns-MRAs.
  • Finerenone shows significant reductions in kidney and cardiovascular outcomes in patients with diabetic kidney disease.
  • Guidelines endorse ns-MRAs for patients with albuminuria despite standard therapy.
  • Combination therapies with SGLT2 inhibitors demonstrate additive benefits.

Structured PICO

P
Population
Patients with type 2 diabetes and chronic kidney disease, particularly those with persistent albuminuria despite optimized standard therapy
I
Intervention
Nonsteroidal mineralocorticoid receptor antagonists (ns-MRA), specifically finerenone, alone or in combination with sodium-glucose cotransporter 2 inhibitors

Nonsteroidal MRAs, particularly finerenone, are emerging as key guideline-endorsed therapies for reducing cardiorenal risk in diabetic kidney disease.

Limitations

  • Real-world effectiveness remains less well defined
  • Efficacy and safety of finerenone in type 1 diabetes patients with CKD remain uncertain

Cite This Study

Jeong et al. (2026) conducted a review in Diabetic kidney disease. Nonsteroidal mineralocorticoid receptor antagonists vs. Standard therapy was evaluated. Nonsteroidal mineralocorticoid receptor antagonists, particularly finerenone, reduce residual kidney and cardiovascular risk in patients with diabetic kidney disease and are recommended as a core component of guideline-directed therapy.

synapsesocial.com/papers/6a48a42489561a0c2d78da6ahttps://doi.org/10.23876/j.krcp.26.233
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Non-steroidal mineralocorticoid receptor antagonists in non-diabetic kidney disease: a narrative review of mechanisms and clinical advances2026
  2. 2Renoprotective Effects of RAAS Inhibitors in Patients with Diabetic Nephropathy: A Comprehensive Meta-Analysis of Randomized Controlled Trials2025 · 1 citations
  3. 3Finerenone in Chronic Kidney Disease: A Comprehensive Review of Mechanisms, Efficacy and Safety2025 · 8 citations
  4. 4The organoprotective effects of finerenone in patients with cardiorenal metabolic syndrome2025
  5. 5Finerenone Improves Albuminuria via MR-TRPC Signaling in Diabetic Kidney Disease2026 · 3 citations