Real‐World Effectiveness and Safety of Finerenone in People With Type 2 Diabetes and Chronic Kidney Disease: A Spanish Multicentre Retrospective Observational Study ( MEDFINE ‐ RWD )
Authors' conclusion
In real-world practice, finerenone was associated with a substantial reduction in albuminuria. Finerenone demonstrated high persistence and a favourable safety profile, irrespective of baseline renoprotective regimens or KDIGO risk.
Study context
- Population
- Adults with T2D and chronic kidney disease (CKD) initiating finerenone, 8 Spanish centres (June 2024–December 2025); median age 72 years, 76.8% male, baseline eGFR 49 mL/min/1.73 m², urinary albumin-to-creatinine ratio (UACR) 285 mg/g, 77.8% high/very high KDIGO riskmedian follow-up 184 days
- Participants
- 844 adults
- Outcome
- ≥ 30% reduction in UACR
Methodological detailsmulticentre, real-world
- Multicentre
- Real-world
Main finding
As reported in the abstract
Primary endpoint achieved, consistently across background renoprotection or baseline KDIGO risk strata
52.7%
Observational data: associations, not effects.
Secondary outcomes
Median UACR reduction · 6 months
- Median UACR reduction with finerenone (p < 0.001)
- 34.5%
- Despite SGLT2i (88.4%) and GLP-1 RA (35.7%) use
Predictors of response (multivariable logistic regression)
- Age ≥ 70, aOR
- 2.12
- Baseline UACR > 245 mg/g, aOR
- 1.94
- BMI > 27 kg/m², aOR
- 1.84
- Insulin use associated with lower response odds
Treatment persistence
- Treatment persistence
- 89.5%
Safety
Hyperkalaemia ≥ 5.5 mmol/L, MAKE and MACE
- Hyperkalaemia
- 4.8%
- MAKE
- 0.9%
- MACE
- 1.1%
Original publication
Real‐World Effectiveness and Safety of Finerenone in People With Type 2 Diabetes and Chronic Kidney Disease: A Spanish Multicentre Retrospective Observational Study ( MEDFINE ‐ RWD ). Diabetes Obes Metab. Published 30 July 2026. doi:10.
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