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Patients with CKD and T2D are at high risk of both developing kidney failure and of cardiovascular events. Renin\u2013angiotensin system (RAS) blockers were considered the cornerstone of treatment of albuminuric CKD in T2D for more than 20 years. However, the residual risk of progression to more advanced CKD stages under RAS blockade remains high, while in major studies with these agents in patients with CKD and T2D no significant reductions in cardiovascular events and mortality were evident. Steroidal mineralocorticoid receptor antagonists (MRAs) are known to reduce albuminuria in individuals on RAS monotherapy, but their wide clinical use has been curtailed by the significant risk of hyperkalemia and absence of trials with hard renal outcomes. In recent years, non-steroidal MRAs have received increasing interest due to their better pharmacologic profile. Finerenone, the first compound of this class, was shown to effectively reduce the progression of kidney disease and of cardiovascular outcomes in participants with T2D in phase 3 trials. This clinical practice document prepared from a task force of the European Renal Best Practice board summarizes current knowledge on the role of MRAs in the treatment of CKD in T2D aiming to support clinicians in decision-making and everyday management of patients with this condition.<\/jats:p>","DOI":"10.1093\/ckj\/sfad139","type":"journal-article","created":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T20:55:23Z","timestamp":1687294523000},"page":"1885-1907","source":"Crossref","is-referenced-by-count":43,"title":["Mineralocorticoid receptor antagonist use in chronic kidney disease with type 2 diabetes: a clinical practice document by the European Renal Best Practice (ERBP) board of the European Renal Association (ERA)"],"prefix":"10.1093","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9174-4018","authenticated-orcid":false,"given":"Pantelis","family":"Sarafidis","sequence":"first","affiliation":[{"name":"Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8863-227X","authenticated-orcid":false,"given":"Fotini","family":"Iatridi","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0577-7081","authenticated-orcid":false,"given":"Charles","family":"Ferro","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Hospitals Birmingham and Institute of Cardiovascular Sciences, University of Birmingham , Birmingham , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Eleni","family":"Alexandrou","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Fernandez-Fernandez","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension , IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz UAM, Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Kanbay","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Koc University School of Medicine , Istanbul , Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Mallamaci","sequence":"additional","affiliation":[{"name":"CNR-IFC, Clinical Epidemiology and Pathophysiology of Hypertension and Renal Diseases , Ospedali Riuniti, Reggio Calabria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ionut","family":"Nistor","sequence":"additional","affiliation":[{"name":"Nephrology Department, University of Medicine and Pharmacy \u201cGrigore 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