# Finerenone Drug · id `cardio:finerenone` · Cardiovascular Atlas · release `5dcd9b263fe17744` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Also called: Finerenone Browse, organ or system: Kidneys Browse, condition area: Diabetes and metabolic disease; Kidney connections ## In plain language The medicine inside Kerendia. It is a pill that blocks the mineralocorticoid receptor and is not a steroid. In the FIDELIO-DKD trial it lowered the risk of kidney disease getting worse in people with chronic kidney disease and type 2 diabetes, and it caused more stopping of the medicine because of high potassium. In the FINEARTS-HF trial in people with heart failure and an ejection fraction of 40% or more, it lowered the rate of a combined outcome of worsening heart failure events and cardiovascular death, with more high potassium; cardiovascular death alone did not clearly differ. ## Technical summary RxNorm ingredient 2562811. A nonsteroidal, selective mineralocorticoid receptor antagonist. In FIDELIO-DKD the primary kidney outcome hazard ratio was 0.82 (95% CI 0.73 to 0.93). Hyperkalemia-related discontinuation was 2.3% on finerenone and 0.9% on placebo. RxClass lists finerenone under the mineralocorticoid receptor antagonist class, which this record links to. The heart-failure trial FINEARTS-HF is in a separate claim: the rate ratio for total worsening heart failure events and cardiovascular death was 0.84 (95% CI 0.74 to 0.95), with more hyperkalemia. ## Claims, with the population each applies to ## Context: Adults with type 2 diabetes, albuminuria, an eGFR of 25 or more and normal potassium, on the highest tolerated RAS inhibitor dose (ADA/KDIGO 2022 consensus report) Recipient: Adult; Population: Adults with type 2 diabetes who have an estimated glomerular filtration rate (eGFR) of 25 mL/min/1.73 m2 or higher, a normal serum potassium and albuminuria (an albumin-to-creatinine ratio of 30 mg/g or more) despite taking the largest dose of a renin-angiotensin system (RAS) inhibitor that they can tolerate. The report speaks of adults and gives no age bounds.; Care setting: Not stated in the report.; Geography: Not stated in the report (a joint report of a US association and an international kidney organization); Life stage: Adults, as the report's introduction puts it (adults with diabetes and CKD); the report gives no age bounds; Follow-up: Not applicable (guidance context) ### The formal consensus statement of the ADA/KDIGO report names a drug class, not finerenone: it recommends a nonsteroidal mineralocorticoid receptor antagonist (ns-MRA) whose kidney and cardiovascular benefit has been proven, for people with type 2 diabetes, an eGFR of 25 mL/min/1.73 m2 or higher, a normal serum potassium and albuminuria (an albumin-to-creatinine ratio of 30 mg/g or more) despite the largest dose of a renin-angiotensin system (RAS) inhibitor that they can tolerate. The report names finerenone as the only ns-MRA with that proof and the only one approved anywhere to slow CKD progression and reduce cardiovascular events, and says adding finerenone is reasonable for people with type 2 diabetes who have persistent albuminuria despite standard treatment with glucose-lowering and blood pressure medicines. - Category: Recommendation - Evidence stage: Guidance - Certainty: Certainty not assessed - Applies to: Recipient: Adult; Population: Adults with type 2 diabetes who have an estimated glomerular filtration rate (eGFR) of 25 mL/min/1.73 m2 or higher, a normal serum potassium and albuminuria (an albumin-to-creatinine ratio of 30 mg/g or more) despite taking the largest dose of a renin-angiotensin system (RAS) inhibitor that they can tolerate. The report speaks of adults and gives no age bounds.; Care setting: Not stated in the report.; Geography: Not stated in the report (a joint report of a US association and an international kidney organization); Life stage: Adults, as the report's introduction puts it (adults with diabetes and CKD); the report gives no age bounds; Follow-up: Not applicable (guidance context) - Limitations: The formal consensus statement names the class and does not name finerenone. This claim sits on finerenone because the report's text and its Figure 3 note name finerenone as the only ns-MRA that met the statement's proviso when the report was written, so a later ns-MRA is not covered. The report's text also names esaxerenone, another ns-MRA, and says it lowered blood pressure and albuminuria but lacks long-term studies with clinical end points. The report advises a potassium check 4 weeks after any dose change and regular checks during treatment, and gives dosing and potassium limits that are not recorded here. The report's trial counts and percentages for finerenone are not recorded; the FIDELIO-DKD claim of this atlas carries that trial's figures. Only the PubMed record and the PMC full text were read. The report is joint ADA and KDIGO guidance drawn from the two organizations' 2022 guidelines, not a trial result, and its consensus statements carry no class of recommendation or level of evidence (the report points to the two organizations' own documents for those). It dates from 2022, so later trials and approvals are not covered. Its licence allows educational, not-for-profit use of the unaltered work, so this atlas restates the statement in its own words. PubMed lists no correction to the report (checked 2026-10-15). - Last checked: 2026-10-15 - Sources: 1. Supports: Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) (Guideline, edition Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.) Locator: ns-MRAs, Consensus Statement. Retrieved 2026-10-15T15:38:41Z. Source state: Current. Snapshot hash: 18bc2637f4a3599a78fcf093fbd32cd604d294579ccd5970a51e0239e485aad7. How it applies: The consensus statement on an ns-MRA. 2. Supports: Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) (Guideline, edition Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.) Locator: Goals of Comprehensive Care, Figure 3 note. Retrieved 2026-10-15T15:38:41Z. Source state: Current. Snapshot hash: 18bc2637f4a3599a78fcf093fbd32cd604d294579ccd5970a51e0239e485aad7. How it applies: Finerenone named as the only member of the class with proven benefit. 3. Supports: Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) (Guideline, edition Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.) Locator: ns-MRAs, para 2 (approval). Retrieved 2026-10-15T15:38:41Z. Source state: Current. Snapshot hash: 18bc2637f4a3599a78fcf093fbd32cd604d294579ccd5970a51e0239e485aad7. How it applies: Finerenone named as the only approved drug of the class for slowing CKD progression. 4. Supports: Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) (Guideline, edition Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.) Locator: ns-MRAs, para 4 (adding finerenone). Retrieved 2026-10-15T15:38:41Z. Source state: Current. Snapshot hash: 18bc2637f4a3599a78fcf093fbd32cd604d294579ccd5970a51e0239e485aad7. How it applies: Adding finerenone is called reasonable. 5. Supports: Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) (Guideline, edition Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.) Locator: ns-MRAs, para 5 (potassium monitoring). Retrieved 2026-10-15T15:38:41Z. Source state: Current. Snapshot hash: 18bc2637f4a3599a78fcf093fbd32cd604d294579ccd5970a51e0239e485aad7. How it applies: Potassium monitoring. 6. Supports: Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) (Guideline, edition Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.) Locator: ns-MRAs, para 2 (esaxerenone). Retrieved 2026-10-15T15:38:41Z. Source state: Current. Snapshot hash: 18bc2637f4a3599a78fcf093fbd32cd604d294579ccd5970a51e0239e485aad7. How it applies: Esaxerenone, another ns-MRA, lacks long-term end-point studies. 7. Background: Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) (Guideline, edition Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.) Locator: Introduction, para 4 (level of evidence). Retrieved 2026-10-15T15:38:41Z. Source state: Current. Snapshot hash: 18bc2637f4a3599a78fcf093fbd32cd604d294579ccd5970a51e0239e485aad7. How it applies: The consensus statements carry no level of evidence. ## Context: Adults with chronic kidney disease and type 2 diabetes (FIDELIO-DKD) Recipient: Adult; Population: Patients with chronic kidney disease and type 2 diabetes who had a urinary albumin-to-creatinine ratio of 30 to below 300, an eGFR of 25 to below 60 and diabetic retinopathy, or a ratio of 300 to 5000 and an eGFR of 25 to below 75. All were treated with renin-angiotensin system blockade adjusted to the maximum label dose they tolerated.; Care setting: Multicenter trial. The care setting is not described further in the sources read.; Geography: Multinational. The registry lists the sites by country on the study page.; Life stage: Adults aged 18 years or older (registry minimum age 18 years); Follow-up: Median follow-up 2.6 years. ### In FIDELIO-DKD, 5734 patients with chronic kidney disease and type 2 diabetes, all on maximum tolerated renin-angiotensin system blockade, were randomly assigned to finerenone or placebo. During a median follow-up of 2.6 years, the primary outcome (kidney failure, a sustained decrease of at least 40% in eGFR from baseline, or death from renal causes) occurred in 504 of 2833 patients (17.8%) on finerenone and 600 of 2841 (21.1%) on placebo (hazard ratio 0.82; 95% CI 0.73 to 0.93; P=0.001). The key secondary outcome (death from cardiovascular causes, nonfatal heart attack, nonfatal stroke or hospitalization for heart failure) occurred in 367 patients (13.0%) and 420 (14.8%) (hazard ratio 0.86; 95% CI 0.75 to 0.99; P=0.03). Overall adverse events were similar in the two groups, but stopping the trial regimen because of high potassium (hyperkalemia) was more frequent on finerenone, 2.3% against 0.9%. - Category: Effect - Evidence stage: Interventional - Certainty: Certainty not assessed - Applies to: Recipient: Adult; Population: Patients with chronic kidney disease and type 2 diabetes who had a urinary albumin-to-creatinine ratio of 30 to below 300, an eGFR of 25 to below 60 and diabetic retinopathy, or a ratio of 300 to 5000 and an eGFR of 25 to below 75. All were treated with renin-angiotensin system blockade adjusted to the maximum label dose they tolerated.; Care setting: Multicenter trial. The care setting is not described further in the sources read.; Geography: Multinational. The registry lists the sites by country on the study page.; Life stage: Adults aged 18 years or older (registry minimum age 18 years); Follow-up: Median follow-up 2.6 years. - Limitations: Participants had to be on renin-angiotensin system blockade and had diabetic kidney disease, so the result does not cover people without diabetes or without that blockade. Funded by Bayer (named in the abstract). Only the PubMed abstract was read. - Last checked: 2026-10-14 - Sources: 1. Supports: Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 1. Retrieved 2026-10-14T18:18:49Z. Source state: Current. Snapshot hash: aa1851e07117283e5bda4286fa413399c6767f2e4854a017e0ea917d59982a1d. How it applies: Primary outcome events by arm, hazard ratio and p-value. 2. Supports: Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 2. Retrieved 2026-10-14T18:18:49Z. Source state: Current. Snapshot hash: aa1851e07117283e5bda4286fa413399c6767f2e4854a017e0ea917d59982a1d. How it applies: Key secondary outcome. 3. Supports: Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 3; Abstract, RESULTS, sentence 4. Retrieved 2026-10-14T18:18:49Z. Source state: Current. Snapshot hash: aa1851e07117283e5bda4286fa413399c6767f2e4854a017e0ea917d59982a1d. How it applies: Adverse events overall and hyperkalemia-related discontinuation. 4. Supports: Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, CONCLUSIONS, sentence 1. Retrieved 2026-10-14T18:18:49Z. Source state: Current. Snapshot hash: aa1851e07117283e5bda4286fa413399c6767f2e4854a017e0ea917d59982a1d. How it applies: The authors conclusion. 5. Background: Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, BACKGROUND, sentence 1; Abstract, METHODS, sentence 4; Abstract, METHODS, sentence 5. Retrieved 2026-10-14T18:18:49Z. Source state: Current. Snapshot hash: aa1851e07117283e5bda4286fa413399c6767f2e4854a017e0ea917d59982a1d. How it applies: What finerenone is, and the primary and key secondary outcome definitions. 6. Background: Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, CONCLUSIONS, sentence 2. Retrieved 2026-10-14T18:18:49Z. Source state: Current. Snapshot hash: aa1851e07117283e5bda4286fa413399c6767f2e4854a017e0ea917d59982a1d. How it applies: Funding line. ## Context: Patients with heart failure and an ejection fraction of 40% or greater (FINEARTS-HF) Recipient: Recipient not specified; Population: Patients with heart failure and a left ventricular ejection fraction of 40% or greater, which covers mildly reduced and preserved ejection fraction.; Care setting: International, double-blind, randomized trial; the abstract does not describe the care setting further.; Geography: International, according to the abstract. The countries were not read.; Life stage: Not stated in the abstract.; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Median follow-up 32 months. ### In FINEARTS-HF, patients with heart failure and a left ventricular ejection fraction of 40% or greater were randomly assigned, in a 1:1 ratio, to finerenone or matching placebo, each on top of usual therapy; the finerenone dose was titrated to a maximum of 20 mg or 40 mg once daily. The primary outcome counted two things together: total worsening heart failure events (first or repeat unplanned hospitalizations or urgent visits for heart failure) and death from cardiovascular causes. Over a median follow-up of 32 months, 1083 primary-outcome events occurred in 624 of 3003 patients on finerenone and 1283 events in 719 of 2998 patients on placebo (rate ratio 0.84; 95% CI 0.74 to 0.95; P=0.007). Worsening heart failure events alone numbered 842 on finerenone and 1024 on placebo (rate ratio 0.82; 95% CI 0.71 to 0.94; P=0.006). Death from cardiovascular causes occurred in 8.1% and 8.7% of patients (hazard ratio 0.93; 95% CI 0.78 to 1.11), an interval that includes 1. Finerenone was associated with more hyperkalemia and less hypokalemia. - Category: Effect - Evidence stage: Interventional - Certainty: Certainty not assessed - Applies to: Recipient: Recipient not specified; Population: Patients with heart failure and a left ventricular ejection fraction of 40% or greater, which covers mildly reduced and preserved ejection fraction.; Care setting: International, double-blind, randomized trial; the abstract does not describe the care setting further.; Geography: International, according to the abstract. The countries were not read.; Life stage: Not stated in the abstract.; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Median follow-up 32 months. - Limitations: One double-blind trial, funded by Bayer (named in the abstract). Only the PubMed abstract was read, not the full paper, and the registry record the abstract names (NCT04435626) was not read. The abstract gives no age limits and no certainty grade. The primary outcome is a composite. Total worsening heart failure events alone were also lower, while for cardiovascular death alone the confidence interval included 1. The abstract gives no size for the hyperkalemia and hypokalemia findings. The ejection fraction band of 40% or greater covers the mildly reduced and the preserved range, and it includes 40% itself, which NHLBI counts in the reduced range, so the result is not specific to the mildly reduced or the preserved type. - Last checked: 2026-10-14 - Sources: 1. Supports: Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. PubMed lists commentary on the paper and no correction.) Locator: Abstract, RESULTS, sentence 1. Retrieved 2026-10-14T18:18:51Z. Source state: Current. Snapshot hash: a5952811b7ff90f593b834a08399a1df3ec77ced0ca460a95a593c31d9a9922b. How it applies: Primary-outcome events and patients by arm, rate ratio and p-value. 2. Supports: Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. PubMed lists commentary on the paper and no correction.) Locator: Abstract, RESULTS, sentence 2. Retrieved 2026-10-14T18:18:51Z. Source state: Current. Snapshot hash: a5952811b7ff90f593b834a08399a1df3ec77ced0ca460a95a593c31d9a9922b. How it applies: Total worsening heart failure events. 3. Supports: Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. PubMed lists commentary on the paper and no correction.) Locator: Abstract, RESULTS, sentence 3; Abstract, RESULTS, sentence 4. Retrieved 2026-10-14T18:18:51Z. Source state: Current. Snapshot hash: a5952811b7ff90f593b834a08399a1df3ec77ced0ca460a95a593c31d9a9922b. How it applies: Cardiovascular death and potassium findings. 4. Supports: Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. PubMed lists commentary on the paper and no correction.) Locator: Abstract, CONCLUSIONS, sentence 1. Retrieved 2026-10-14T18:18:51Z. Source state: Current. Snapshot hash: a5952811b7ff90f593b834a08399a1df3ec77ced0ca460a95a593c31d9a9922b. How it applies: The authors conclusion. 5. Background: Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. PubMed lists commentary on the paper and no correction.) Locator: Abstract, METHODS, sentence 1; Abstract, METHODS, sentence 2. Retrieved 2026-10-14T18:18:51Z. Source state: Current. Snapshot hash: a5952811b7ff90f593b834a08399a1df3ec77ced0ca460a95a593c31d9a9922b. How it applies: Population, doses and the primary outcome definition. 6. Background: Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. PubMed lists commentary on the paper and no correction.) Locator: Abstract, CONCLUSIONS, sentence 2. Retrieved 2026-10-14T18:18:51Z. Source state: Current. Snapshot hash: a5952811b7ff90f593b834a08399a1df3ec77ced0ca460a95a593c31d9a9922b. How it applies: Funding line. ## Guidance, authorization and access ### Recommendation `cardio:rec-ada-kdigo-2022-ns-mra` - Drug: Finerenone (`cardio:finerenone`) - Direction: Recommended - Issued by: Kidney Disease: Improving Global Outcomes (KDIGO) (`cardio:kdigo`) - Guideline record: ADA/KDIGO 2022 consensus report on diabetes management in CKD (`cardio:guideline-ada-kdigo-2022-consensus`) - Guideline: Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO), edition Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.; snapshot `cardio:pmc-pmc9870667-2026-10-15` - Jurisdictions: Not stated; note: A joint report of a US association and an international kidney organization; the report names no jurisdiction. Only one of the two issuers can be recorded here; the guideline record lists both. - Strength: Consensus statement; the report prints no class of recommendation (The report prints no class or level of evidence for its consensus statements, so none is recorded.) - Effective: 2022-12 (The December 2022 issue of Diabetes Care, as PubMed gives it; the report was published online on 3 October 2022.) - Supersession: Not checked - Applies to: Recipient: Adult; Population: Adults with type 2 diabetes who have an estimated glomerular filtration rate (eGFR) of 25 mL/min/1.73 m2 or higher, a normal serum potassium and albuminuria (an albumin-to-creatinine ratio of 30 mg/g or more) despite taking the largest dose of a renin-angiotensin system (RAS) inhibitor that they can tolerate. The report speaks of adults and gives no age bounds.; Care setting: Not stated in the report.; Geography: Not stated in the report (a joint report of a US association and an international kidney organization); Life stage: Adults, as the report's introduction puts it (adults with diabetes and CKD); the report gives no age bounds; Follow-up: Not applicable (guidance context) - Basis: claim `cardio:claim-ada-kdigo-2022-ns-mra-finerenone` ## Connected pages - FIDELIO-DKD looked at kidney failure, eGFR decline and renal death in people with type 2 diabetes: Chronic kidney disease (CKD) (`cardio:chronic-kidney-disease`) [a claim, not a settled fact; see claim `cardio:claim-fidelio-dkd-kidney-effect` and its context] - Finerenone is a mineralocorticoid receptor antagonist (FDA mechanism-of-action class in RxClass): Mineralocorticoid receptor antagonists (drug class) (`cardio:mineralocorticoid-receptor-antagonists`) - FINEARTS-HF: lower rate of the combined outcome of worsening heart failure events and cardiovascular death than placebo, with more hyperkalemia: Heart failure with mildly reduced or preserved ejection fraction (`cardio:hfpef`) [a claim, not a settled fact; see claim `cardio:claim-finearts-hf-primary-effect` and its context] - Filed under this front: Kidney and metabolic care (`cardio:front-kidney-and-metabolic-care`) - ADA/KDIGO 2022 consensus report, whose formal statement names the drug class (a nonsteroidal MRA), not finerenone: adults with type 2 diabetes and albuminuria, an eGFR of 25 or more and normal potassium despite the largest tolerated RAS inhibitor dose: Chronic kidney disease (CKD) (`cardio:chronic-kidney-disease`) [a claim, not a settled fact; see claim `cardio:claim-ada-kdigo-2022-ns-mra-finerenone` and its context] - Related to: Kidney and heart protection in diabetes and chronic kidney disease (`cardio:pathway-ckd-type-2-diabetes`) - Contained in: Finerenone (Kerendia) (`cardio:kerendia`) - Investigated in: FIDELIO-DKD: finerenone and kidney outcomes in type 2 diabetes (`cardio:fidelio-dkd`) ## Provenance Content hash: cfbf4d795beb066c49211aba01574810bcb0d8fb8f150f523821327a535ba64c Last substantive edit: 2026-10-14 Evidence last checked: Not recorded