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Review
. 2025 Feb 8;26(1):63.
doi: 10.1186/s12882-025-03985-9.

Finerenone in the management of diabetes kidney disease

Parijat De  1 , May T Khine  1 , Andrew Frankel  2 , Gabrielle Goldet  3 , Debasish Banerjee  4 , Rosa M Montero  4 , Tahseen A Chowdhury  5 , Damien Fogarty  6 , Janaka Karalliedde  7 , Ritwika Mallik  8 , Dipesh C Patel  9 , Mona Wahba  10 , Peter Winocour  11 , Sagen Zac-Varghese  11 , Stephen Bain  12 , Adnan Sharif  13 , Srikanth Bellary  13 , Indranil Dasgupta  13
Affiliations
Review

Finerenone in the management of diabetes kidney disease

Parijat De et al. BMC Nephrol. .

Abstract

People with type 2 diabetes are at risk of developing progressive diabetic kidney disease (DKD) and end stage kidney failure. Hypertension is a major, reversible risk factor in people with diabetes for development of albuminuria, impaired kidney function, end-stage kidney disease and cardiovascular disease. Slowing progression of kidney disease and reducing cardiovascular events can be achieved by a number of means including the targeting of blood pressure and the use of specific classes of drugs The use of Renin Angiotensin Aldosterone System (RAAS) blockade is effective in preventing or slowing progression of DKD and reducing cardiovascular events in people with type 2 diabetes, albeit differently according to the stage of DKD. However, emerging therapy such as non-steroidal selective mineralocorticoid antagonists (finerenone) is proven to lower blood pressure and further reduce the risk of progression of DKD and cardiovascular disease in people with type 2 diabetes. This consensus reviews current evidence and make recommendations for the use of finerenone in the management of diabetes kidney disease in the UK.

Keywords: ACE inhibitors; Albuminuria; Angiotensin receptor blockers; Diabetes; Diabetic kidney disease; Finerenone; Hypertension; Renin Angiotensin Aldosterone System (RAAS).

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: This document was reviewed across the entire membership of the guideline group which is a joint committee of both the Association of British Clinical Diabetologist (ABCD) and UK Kidney Association (UKKA). AF has attended drug advisory boards of Boehringer Ingleheim, AstraZeneca, NAPP, Novo Nordisk, MSD, VP UK. PW has received honoraria for delivering educational meetings and/or attending advisory boards for Abbott, Astra Zeneca, Bayer, Boehringer Ingleheim, Eli Lilly, MSD, NAPP, Sanofi, Novo and Vifor Pharmaceuticals. SCB reported receiving personal fees from AstraZeneca, Boehringer Ingelheim, Eli Lilly, Merck Sharp & Dohme, Novo Nordisk and Sanofi-Aventis (honoraria); Medscape (funding for the development of educational programmes); All Wales Medicines Strategy Group and National Institute for Health and Care Excellence UK (providing expert advice) and is a shareholder of Glycosmedia. SB has received speaker fees and support to attend educational meetings from AstraZeneca, Novo Nordisk, Eli Lilly and Boehringer Ingelheim. PD has received honoraria for educational meetings from AstraZeneca, Janssen, Boehringer Ingelheim, Novo, Sanofi, Novartis, Abbott, MSD, Takeda, Roche, Lilly, Ascensia, BD, Internis, GSK, Menarini, Daichi-Sankyo, Bayer and Besins. DB has received grant from AstraZeneca and speaker fees from Vifor Pharma. JK has received honoraria for delivering educational meetings and/or attending advisory boards from Boehringer Ingelheim, AstraZeneca, Sanofi, NAPP and research grants from AstraZeneca and Sanofi. ID is chief investigator in the UK for three GSK sponsored trials and has chaired GSK advisory board. He has received a research grant from Sanofi Genzyme. Other authors have declared no competing interests. Clinical trial number: Not applicable.

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