Finerenone in the management of diabetes kidney disease

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.