Finerenone reduces cardiovascular and kidney disease risk in type 2 diabetes
Last updated May 16, 2026
Key finding
Finerenone reduces heart and kidney disease risk in type 2 diabetes with kidney disease.
This systematic review analyzed 8 studies involving over 13,000 adults with type 2 diabetes and chronic kidney disease. The studies tested finerenone, a newer medication that blocks certain hormone receptors, added to standard care. Participants already taking medications to protect their kidneys were followed for about 3 years. Results showed finerenone reduced the risk of heart attacks, strokes, heart failure hospitalization, and cardiovascular death by 14%, and lowered the risk of kidney failure or major kidney function decline by 23%. Benefits were seen across different patient groups, though elderly patients over 75 showed less kidney protection. The main side effect was higher potassium levels, but few people stopped treatment because of it.
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Study at a glance
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EvidenceScore™
High
Study type
Systematic Review
Follow-up
Medium-Term (3–12 mo)
Risk of bias
Low Risk
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Plain-language summary
What this paper says
A plain-language read of the study’s main message and where it applies.
Study focus
Finerenone reduces heart and kidney disease risk in type 2 diabetes with kidney disease.
Published in
Journal Reference
Publication details and source links for this paper.
Bachar Al Sumodi W, Sajjad M, Rana SU, Ahmed G, Hans A, Mirani W. Effects of Contemporary Therapies on Cardiovascular and Renal Outcomes in Diabetic Kidney Disease: A Systematic Review of Randomized Controlled Trials (RCTs). Cureus. 2025;17(10):e95400. doi:10.7759/cureus.95400
Main Effects
Cardiovascular events → ↓ (moderate reduction, 14%)
Kidney failure/function decline → ↓ (strong reduction, 23%)
Potassium levels → ↑ (increased, but rarely leading to stopping treatment)
Evidence Suggest
- Finerenone appears to reduce both heart-related events and kidney disease progression in people with type 2 diabetes and kidney disease.
- The medication lowered the combined risk of heart attack, stroke, heart failure hospitalization, and cardiovascular death by 14%, with even greater protection against kidney failure.
- Benefits were fairly consistent across different patient groups, though evidence is limited for elderly people over 75 and those with very advanced kidney disease.
Who this applies to
Adults with type 2 diabetes and chronic kidney disease who are already taking medications to protect their kidneys (ACE inhibitors or ARBs). Benefits were seen across different stages of kidney disease, though evidence is strongest for people with mild to moderate kidney impairment. Results may apply less directly to women, people over 75, or those with very advanced kidney disease, as these groups were underrepresented in the studies.
Keep in Mind
Most study participants were male and under 75 years old, so results may not fully apply to women or elderly patients.
Between the Lines
- Few women and elderly participants
- Limited data on advanced kidney disease
- Follow-up only 3 years
- Highly selected study populations
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