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.
Quick read
The essential study design details in one scan.
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
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
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
Cardiovascular events → ↓ (moderate reduction, 14%)
Kidney failure/function decline → ↓ (strong reduction, 23%)
Potassium levels → ↑ (increased, but rarely leading to stopping treatment)
Evidence network
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This study contributes evidence to Finerenone (nonsteroidal mineralocorticoid receptor antagonist) and Albuminuria, Cardiovascular events, Composite renal outcomes (kidney failure, sustained eGFR decline ≥57%, renal death), and 1 more.
This study contributes evidence to
Primary intervention
Finerenone (nonsteroidal mineralocorticoid receptor antagonist)
Primary outcomes
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
2
Related topics
4
Evidence pairs
106
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Contributes evidence
Evidence topic
Contributes evidence
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Primary evidence
Evidence topic
matched_intervention_and_outcome
Related evidence
Evidence topic
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Core evidence
The primary outcomes reported in this study.
Finerenone (nonsteroidal mineralocorticoid receptor antagonist) → Albuminuria
Finerenone (nonsteroidal mineralocorticoid receptor antagonist) → Albuminuria
Finerenone (nonsteroidal mineralocorticoid receptor antagonist) → Cardiovascular events
Finerenone (nonsteroidal mineralocorticoid receptor antagonist) → Cardiovascular events
Finerenone (nonsteroidal mineralocorticoid receptor antagonist) → Composite renal outcomes (kidney failure, sustained eGFR decline ≥57%, renal death)
Finerenone (nonsteroidal mineralocorticoid receptor antagonist) → Composite renal outcomes (kidney failure, sustained eGFR decline ≥57%, renal death)
Finerenone (nonsteroidal mineralocorticoid receptor antagonist) → Hospitalization rate
Finerenone (nonsteroidal mineralocorticoid receptor antagonist) → Hospitalization rate
Evidence Library
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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.
Most study participants were male and under 75 years old, so results may not fully apply to women or elderly patients.
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Finerenone (nonsteroidal mineralocorticoid receptor antagonist) and Kidney Function, Finerenone (nonsteroidal mineralocorticoid receptor antagonist) and Cardiovascular Outcomes.
This study contributes to the evidence on the following intervention-outcome relationships.
Medications
Curated evidence collections and hubs this study is part of.
All studies measuring Cardiovascular Outcomes
Measures Cardiovascular Outcomes as a key outcome.
All studies on Finerenone (nonsteroidal mineralocorticoid receptor antagonist)
Contributes to Finerenone (nonsteroidal mineralocorticoid receptor antagonist) evidence base.
All studies measuring Kidney Function
Measures Kidney Function as a key outcome.
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1 results
1 results
1 results
1 results
1 results
Generated from the study's connected evidence using Evidence Intelligence™.
Finerenone (nonsteroidal mineralocorticoid receptor antagonist) appears to improve Albuminuria.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Albuminuria
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Finerenone (nonsteroidal mineralocorticoid receptor antagonist) appears to improve Cardiovascular events.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Cardiovascular events
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Finerenone (nonsteroidal mineralocorticoid receptor antagonist) appears to improve Composite renal outcomes (kidney failure, sustained eGFR decline ≥57%, renal death).
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Composite renal outcomes (kidney failure, sustained eGFR decline ≥57%, renal death)
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Finerenone (nonsteroidal mineralocorticoid receptor antagonist) appears to improve Hospitalization rate.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Hospitalization rate
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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