Role of Finerenone in the Treatment of Diabetic Kidney Disease: Patient Selection and Clinical Perspectives.

Diabetes is the leading cause of chronic and end stage kidney disease globally. Despite recent advances in therapies for diabetic kidney disease (DKD), there remains a critical need for additional options to improve renal and cardiovascular outcomes. Mineralocorticoid overactivation contributes to inflammation and fibrosis which in turn leads to progression of DKD. Finerenone, a novel non-steroidal mineralocorticoid receptor antagonist, has shown promising cardiac and renoprotective benefits in DKD. The utility of finerenone in the real world will require appropriate patient selection and patient monitoring by clinicians.