ArticleNature communications2025
Finerenone versus spironolactone in patients with chronic kidney disease and type 2 diabetes: a target trial emulation.
Article in Nature communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Mineralocorticoid receptor antagonists in dialysis patients after ACHIEVE and ALCHEMIST: updated systematic review and meta-analysis of 14 randomized trials.Renal failure · 2026Pooled it
- Hyperkalemia risk with finerenone in diabetic kidney disease: a real-world analysis from the FINE-TURK cohort.Clinical kidney journal · 2026Article
- Clinical practice recommendations for the management of Alport syndrome: a joint statement of the Korean Society of Nephrology and the Korean Society of Pediatric Nephrology.Kidney research and clinical practice · 2026Article
- Finerenone vs. spironolactone to reduce adverse outcomes in patients with cardiac-kidney-metabolic syndrome complicated by atrial fibrillation: findings from the Tianjin atrial fibrillation project.European heart journal open · 2026Article
- Diabetic kidney disease, biomarkers, and finerenone.Diabetes, obesity & metabolism · 2026Review
- From mechanisms to clinical practice: a review of diuretic therapy in pediatric nephrology.Pediatric nephrology (Berlin, Germany) · 2026Article
- [Consensus recommendations on the diagnosis and treatment of hyperkalemia of the Austrian Society of Nephrology 2026].Wiener klinische Wochenschrift · 2026Review
- Emerging therapeutic pipelines on kidney fibrosis: challenges in translational research.Journal of translational medicine · 2026Review
- Residual Renal Risk in Diabetic Nephropathy Despite Contemporary Therapies.Journal of clinical medicine · 2026Review
- Drug-induced hyperuricemia: multi-pathway regulation, causative drugs, and individualized management strategies.Frontiers in pharmacology · 2026Review
- Effect of finerenone on renal function in patients with type 2 diabetic nephropathy: a retrospective cohort study.Frontiers in endocrinology · 2026Article
- Hemodynamic effects of finerenone on blood pressure and heart rate in hospitalized patients with type 2 diabetes: a real-world study.Frontiers in endocrinology · 2026Observational
- The clinical value of PLR, NLR, and MLR in predicting mortality risk in hospitalized patients.Frontiers in pharmacology · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The comparative effectiveness of finerenone and spironolactone in chronic kidney disease (CKD) with type 2 diabetes (T2D) remains unclear. Here we show, using a target trial emulation on global real-world data from TriNetX, outcomes among 2268 propensity score-matched adults with CKD (eGFR 15-60 mL/min/1.73 m²) and T2D who initiated finerenone or spironolactone between July 2021 and September 2024. Over a median follow-up of 1.3 years, finerenone is associated with lower risks of major adverse cardiovascular events (adjust hazard ratio [aHR], 0.74; 95% CI, 0.58-0.94), major adverse kidney events (aHR, 0.47; 95% CI, 0.33-0.67), all-cause mortality (aHR, 0.31; 95% CI, 0.21-0.45), and hyperkalemia (17.2% vs. 26.4%; P < 0.001) compared with spironolactone. These findings suggest potential benefits of finerenone over spironolactone in reducing mortality and cardiorenal risk among patients with CKD and T2D.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.