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CKD Nephroprotection

Finerenone

Brand names: Kerendia

Finerenone is a non-steroidal, selective mineralocorticoid receptor antagonist licensed to slow progression of chronic kidney disease associated with type 2 diabetes and reduce cardiovascular events, added to renin-angiotensin system blockade.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It selectively blocks the mineralocorticoid receptor, reducing aldosterone-driven inflammation and fibrosis in the kidney and heart with less effect on electrolytes than steroidal MRAs.

Prescribing in practice

  • Hyperkalaemia is the key risk: check serum potassium before initiation and do not start if it is elevated above the SPC threshold.
  • Avoid concomitant strong CYP3A4 inhibitors, which substantially raise finerenone exposure.
  • It is contraindicated in Addison's disease and should not be combined routinely with other potassium-sparing agents or potassium supplements.

Monitoring

Measure serum potassium and eGFR at baseline and during follow-up, adjusting or interrupting therapy according to potassium results.

Counselling the patient

  • Regular blood tests for potassium and kidney function are essential while on this medicine.
  • Avoid potassium-based salt substitutes and tell clinicians about all other medicines you take.
  • Report muscle weakness, palpitations or fatigue, which may indicate a high potassium level.

Evidence & guidelines

The FIDELIO-DKD and FIGARO-DKD trials demonstrated kidney and cardiovascular benefit in CKD with type 2 diabetes, supporting NICE recommendations.

Reference: FIDELIO-DKD (Bakris et al. NEJM 2020); FIGARO-DKD (Pitt et al. NEJM 2021); FIDELITY Analysis; NICE TA877; SPC Kerendia; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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