Finerenone reduces cardiovascular and kidney disease risk in type 2 diabetes

High confidence

Low bias

Last updated May 16, 2026

Key takeaway:

Finerenone reduces heart and kidney disease risk in type 2 diabetes with kidney disease.

Study at a glance

What was studied

8 studies with over 13,000 adults with type 2 diabetes and kidney disease over 3 years

Study type

Systematic Review

duration

Medium-Term (3–12 mo)

Intervention

Finerenone

Outcomes

Cardiovascular events, Composite kidney outcomes, Hospitalization rate, Albuminuria, (no title)

Funding

Non-industry sponsored

Main effects

Cardiovascular events → ↓ (moderate reduction, 14%)

Kidney failure/function decline → ↓ (strong reduction, 23%)

Potassium levels → ↑ (increased, but rarely leading to stopping treatment)

Evidence Summary

Intervention	Outcome	Measured Change	Study Effect
Finerenone (nonsteroidal mineralocorticoid receptor antagonist) (Medications)	Albuminuria (Clinical Outcomes)	Decrease	Strong
Finerenone (nonsteroidal mineralocorticoid receptor antagonist) (Medications)	Cardiovascular events (Clinical Outcomes)	Decrease	Strong
Finerenone (nonsteroidal mineralocorticoid receptor antagonist) (Medications)	Composite renal outcomes (kidney failure, sustained eGFR decline ≥57%, renal death) (Clinical Outcomes)	Decrease	Strong
Finerenone (nonsteroidal mineralocorticoid receptor antagonist) (Medications)	Hospitalization rate (Clinical Outcomes)	Decrease	Strong

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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

Journal Reference

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

Connected Evidence

Discover how this study fits into the broader diabetes evidence landscape.

This study contributes to evidence on Finerenone (nonsteroidal mineralocorticoid receptor antagonist) and Albuminuria, Finerenone (nonsteroidal mineralocorticoid receptor antagonist) and Cardiovascular events.