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REVIEW article

Front. Med.

Sec. Nephrology

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1580645

Finerenone in Diabetic Kidney Disease: A New Frontier for Slowing Disease Progression

Provisionally accepted
Ibrahim S. AlhomoudIbrahim S. Alhomoud1,2*Mohamed A. AlbekeryMohamed A. Albekery3Razan AlqadiRazan Alqadi4Amal AlqumiaAmal Alqumia5Riaz A. KhanRiaz A. Khan6Muthana Al SahlawiMuthana Al Sahlawi7Mohammed Yousef Al MulhimMohammed Yousef Al Mulhim7
  • 1Qassim University, Buraidah, Saudi Arabia
  • 2Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraydah, Saudi Arabia
  • 3College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Eastern Province, Saudi Arabia
  • 4Department of Pharmacy, King Saud Hospital, Unaizah, Saudi Arabia
  • 5King Fahd Specialist Hospital, buraydah, Saudi Arabia
  • 6Department of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, Qassim University, Buraidah, Saudi Arabia
  • 7Department of Internal Medicine, College of Medicine, King Faisal University, Al Hofuf, Saudi Arabia

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Diabetic kidney disease (DKD) represents a substantial health burden for patients with type 2 diabetes mellitus (T2DM), markedly increasing morbidity and mortality. The cornerstone of DKD treatment remains renin-angiotensin system (RAS) blockade and risk factor control, such as blood pressure management, glycemic control, albuminuria reduction, and lipid management. However, treatment strategies have expanded to include sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists, which have proven effective in slowing kidney disease progression when combined with RAS inhibitors. Finerenone, a non-steroidal mineralocorticoid receptor antagonist (MRA), represents a novel approach to the management of DKD. It offers unique pharmacokinetic and pharmacodynamic properties compared with steroidal MRAs such as spironolactone and eplerenone. This review addresses the evolving landscape of diabetic kidney disease management, with a focus on finerenone's distinct pharmacologic properties, structural characteristics, and clinical implications.

Keywords: finerenone, Diabetes Mellitus, diabetic kidney disease (DKD), Chronic kidney disease (CKD), mineralocorticoid receptor antagonists (MRA)

Received: 21 Feb 2025; Accepted: 09 May 2025.

Copyright: © 2025 Alhomoud, Albekery, Alqadi, Alqumia, Khan, Al Sahlawi and Al Mulhim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Ibrahim S. Alhomoud, Qassim University, Buraidah, Saudi Arabia

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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