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The mineralocorticoid aldosterone has inflammatory and fibrotic effects on myocardium, which is one reason that the mineralocorticoid-receptor antagonists spironolactone and eplerenone are beneficial in heart failure. Because aldosterone also seems to have deleterious effects on the kidney, aldosterone antagonism might have a role in treating chronic kidney disease (CKD). In this industry-sponsored, phase III randomized trial, 5700 patients with type 2 diabetes and CKD (mean estimated glomerular filtration rate [eGFR], 44 mL/minute/1.73 m2) received either finerenone — a nonsteroidal mineralocorticoid-receptor antagonist that is not yet FDA-approved — or placebo. Nearly all patients also were taking angiotensin-converting–enzyme inhibitors …