Finerenone: A Novel Non-Steroidal MRA for Diabetic Kidney Disease and Cardiovascular Risk Reduction

Diuretics are mainly used in the management of hypertension, chronic kidney disease (CKD), heart failure, and numerous hypervolemic disorders. Different diuretics work on different ion channels together with the nephron, increasing sodium excretion through urination. Promoting the renin-angiotensin-aldosterone system (RAAS) pathway causes the construction of the steroid hormone aldosterone by the adrenal cortex, which acts on receptors in the distal and collecting tubules of the nephron, promoting the secretion of potassium and reabsorption of sodium. Finerenone is a newly approved non-steroidal mineralocorticoid receptor antagonist (MRA) indicated for chronic kidney disease (CKD) in patients with type 2 diabetes (T2D). This review summarizes its pharmacological action, clinical efficacy from major trials, and safety profile. Compared to older MRAs, finerenone offers improved receptor selectivity and reduced risk of hyperkalemia.