🎙️Proud to share, Real-World Effectiveness and Safety of Finerenone in People With Type 2 Diabetes and Chronic Kidney Disease: A Spanish Multicentre Retrospective Observational Study (MEDFINE-RWD)🆓🇪🇸 doi.org/10.1111/dom.71160 #endopower 👥 N 844 (age 72 years; FU 184 days; 76.8% male; eGFR 49 mL/min/1.73 m2; UACR 285 mg/g; 77.8% were at high/very high KDIGO risk) 📊 finerenone was associated ⬇️ 34.5% UACR at 6 M (p < 0.001), despite intensive SGLT2 inhibitors (88.4%) and GLP-1 RA (35.7%) use. The primary endpoint was achieved by 52.7%, consistently across background renoprotection or baseline KDIGO risk strata. 📉 Predictors of response were age ≥ 70 (aOR 2.12), baseline UACR > 245 mg/g (aOR 1.94), and BMI > 27 kg/m2 (aOR 1.84), while insulin use was associated with lower response odds. 🚨Treatment persistence was 89.5%, with low incidences of hyperkalaemia (4.8%), MAKE (0.9%), and MACE (1.1%). 🚩What is new? • Detailed characterization of a large cohort managed under contemporary standard of care, with ~90% on SGLT2 inhibitors and ~40% on GLP-1 RA. • We adopted a ≥ 30% UACR reduction as the primary endpoint—a validated surrogate for long-term kidney protection, filling a real knowledge gap in comparative real-world data. • Factors linked to renal response offers a granular view of drug performance in daily practice and supports rapid-sequence up-titration of guideline-directed medical therapy for PWT2D and CKD. • In RW treatment persistence was high, with the cumulative incidence of hyperkalaemia < 5%. 🚩How might this study influence clinical practice? The MEDFINE-RWD study provides pragmatic evidence that finerenone is associated with a favourable benefit–risk profile when integrated into cutting-edge multimodal therapeutic frameworks. 👉🏻 The identification of independent response predictors offers key insights for clinical stratification. 👉🏻 These findings advocate for the early consideration of finerenone as a cornerstone of comprehensive nephroprotective strategies designed to bridge the ‘residual risk’ gap. @isabial_iis @GVAsanitat @wileyinresearch @diabeteSEEN @SEDiabetes @secardiologia @SENefrologia @Sociedad_SEMI @SEMERGENap @semfyc @fjavesc @cristinatejerap @CristobMorales @DrTinahones @ADA_DiabetesPro @EASDnews @EASDelearning @TheAACE @ThaerIdrees @InzucchiSE @AnnePetersMD @EricTopol @PepaSolerR @jlgorriz @rebecareyesgar1 @inesmodrego @ERAkidney @ASNKidney