A study in the Journal of the American Medical Association (JAMA) revealed that most patients with diabetes and kidney disease take an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker; adding finerenone to this drug improved albuminuria compared to adding placebo. George L. Bakris, M.D., of the University of Chicago School of Medicine, and colleagues randomly assigned 823 diabetic patients with increased urinary albumin (821 taking the study drug) taking an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker to receive different doses of finerenone in either the group or the placebo group. In previous studies, finerenone was shown to reduce albuminuria in patients with chronic kidney disease and heart failure and to have a reduced incidence of hyperkalemia compared with another drug. The current study was conducted at 148 sites in 23 countries. At the start of this study, 37% of the patients treated had very high albuminuria. Researchers found that at day 90, finerenone reduced albuminuria in a dose-dependent manner; compared to placebo, finerenone significantly reduced albuminuria in the 7.5- 20 mg/day dose group, with a range of 21% to 38% reduction. In the placebo and 10 mg/day finerenone dose groups, researchers did not observe discontinuation due to hyperkalemia; in the 7.5-, 15-, and 20-mg/day finerenone groups, the percentage of discontinuations due to hyperkalemia was 2.1%, 3.2%, and 1.7%, respectively. There were no differences in the estimated glomerular filtration rate reduction of 30% or more, the incidence of adverse events, or serious adverse events in the placebo and finerenone groups compared to each other.