Finerenone in diabetic CKD (FIDELIO-DKD / FIGARO-DKD, FIDELITY)

Evidence tier

Established · MRA

Plain-language summary

Across the FIDELIO-DKD and FIGARO-DKD programme (FIDELITY pooled analysis), the non-steroidal mineralocorticoid-receptor antagonist finerenone reduced kidney and cardiovascular events in type 2 diabetes with CKD — the fourth pillar of cardio-reno-metabolic protection.

Key findings

  • FIDELIO-DKD: improved kidney and cardiovascular outcomes in advanced CKD.
  • FIGARO-DKD: reduced cardiovascular events across stage 1–4 CKD.
  • Hyperkalemia is the key monitorable safety signal.

Population

Type 2 diabetes with CKD (albuminuria); finerenone vs placebo on background RAS blockade.

What this does not prove

Studied in T2D with albuminuric CKD on RAS blockade; hyperkalemia risk requires monitoring. Not studied as an obesity therapy.

Primary source

Agarwal R, et al. Eur Heart J. 2022;43:474–484.
https://academic.oup.com/eurheartj/article/43/6/474/6433104

Educational only

Paraphrased from the primary publication; not individual medical advice. Verify against the source before applying to care.