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This review summarizes the rationale, clinical evidence and practical implementation for non\u2010steroidal mineralocorticoid receptor antagonists (nsMRAs), a drug class now approved and recommended for patients with T2D and CKD at risk of cardiorenal disease progression. Three nsMRAs (finerenone, esaxerenone and apararenone) have been evaluated but finerenone is currently the only approved nsMRA for this indication. Two large\u2010scale, placebo\u2010controlled, Phase 3 studies evaluated finerenone added to a maximally tolerated dose of an angiotensin\u2010converting enzyme inhibitor or an angiotensin II receptor blocker. Over &gt;2\u2009years of treatment, finerenone was associated with a significant reduction in composite endpoints of renal and cardiovascular outcomes versus placebo. Esaxerenone or apararenone have both shown significant improvements in albuminuria versus placebo. In general, nsMRAs were well tolerated. Hyperkalaemia was the most notable treatment\u2010related adverse event and could generally be managed through serum potassium monitoring and dose adjustments. The nsMRAs are now an important component of recommended treatment for CKD associated with T2D, providing a significant reduction in the risk of cardiorenal progression beyond what can be achieved with glucose and blood pressure control.<\/jats:p>","DOI":"10.1111\/dom.15327","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T03:25:06Z","timestamp":1698377106000},"page":"417-430","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Non\u2010steroidal mineralocorticoid receptor antagonists in patients with chronic kidney disease and type 2 diabetes"],"prefix":"10.1111","volume":"26","author":[{"given":"Carolina","family":"Solis\u2010Herrera","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Department of Medicine University of Texas Health  San Antonio Texas 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