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FIDELIO-DKD Finerenone Trial — ESENeph MCQ

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ModerateDiabetic Kidney DiseaseFIDELIO-DKD Finerenone TrialESENeph

A 50-year-old man with type 2 diabetes and CKD G3b has persistent albuminuria (uACR 95 mg/mmol) despite Ramipril and Dapagliflozin. His potassium is 4.3 mmol/L and eGFR is 35. He is started on Finerenone 10 mg. What key trial demonstrated Finerenone kidney benefit?

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Correct answer: C — FIDELIO-DKD – demonstrated that Finerenone reduced the composite of sustained eGFR decline, kidney failure, and renal death by 18% in T2D with CKD

FIDELIO-DKD (2020) was the landmark trial demonstrating kidney benefit of Finerenone (nonsteroidal MRA) in patients with T2D and CKD. The primary composite endpoint (sustained ≥40% eGFR decline, kidney failure, renal death) was reduced by 18%. FIGARO-DKD (2021) showed cardiovascular benefit. Together, they establish Finerenone as the third pillar (alongside RASi and SGLT2i) for diabetic CKD. KDIGO 2024 recommends Finerenone for T2D with CKD, albuminuria, eGFR >25, and normal potassium.

Reference: FIDELIO-DKD – NEJM 2020; KDIGO 2024 – CKD