The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index; 9 of the 18 sources its claims cite were checked for support.
Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes
Open accessAbstract
BACKGROUND: Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials involving patients with chronic kidney disease (CKD) and type 2 diabetes. However, its long-term effects on kidney and cardiovascular outcomes are unknown. METHODS: . All the patients were treated with renin-angiotensin system blockade that had been adjusted before randomization to the maximum dose on the manufacturer's label that did not cause unacceptable side effects. The primary composite outcome, assessed in a time-to-event analysis, was kidney failure, a sustained decrease of at least 40% in the eGFR from baseline, or death from renal causes. The key secondary composite outcome, also assessed in a time-to-event analysis, was death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. RESULTS: During a median follow-up of 2.6 years, a primary outcome event occurred in 504 of 2833 patients (17.8%) in the finerenone group and 600 of 2841 patients (21.1%) in the placebo group (hazard ratio, 0.82; 95% confidence interval [CI], 0.73 to 0.93; P = 0.001). A key secondary outcome event occurred in 367 patients (13.0%) and 420 patients (14.8%) in the respective groups (hazard ratio, 0.86; 95% CI, 0.75 to 0.99; P = 0.03). Overall, the frequency of adverse events was similar in the two groups. The incidence of hyperkalemia-related discontinuation of the trial regimen was higher with finerenone than with placebo (2.3% and 0.9%, respectively). CONCLUSIONS: In patients with CKD and type 2 diabetes, treatment with finerenone resulted in lower risks of CKD progression and cardiovascular events than placebo. (Funded by Bayer; FIDELIO-DKD ClinicalTrials.gov number, NCT02540993.).
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Claims the paper makes
36 Own result · 18 Own method · 6 Partly supported · 5 Own interpretation · 5 No basis given · 2 Supported · 1 Supported so far · accuracy not yet measured
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In the paper
“First, the patient populations differed in the two trials”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Discussion
What the sources say
- Partly supportedcites [4] 4. Perkovic V, Jardine MJ, Neal B, et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med 2019; 380: 2295-306. sourceExperimental — accuracy not yet measured
The introduction (page not supplied) describes CREDENCE patients as having type 2 diabetes and albuminuric chronic kidney disease, and contrasts them with patients in earlier trials who were at low risk for kidney failure. The Patients section gives CREDENCE baseline characteristics. But the cited paper does not identify or describe the citing document’s “this trial,” so it cannot establish that those two specific patient populations differed. (LLM, conf=0.72)
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The magnitude of the between-group difference in the risk of a primary outcome event was smaller than that shown for the SGLT2 inhibitor canagliflozin in the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial.4”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Discussion
What the sources say
- Supportedcites [4] 4. Perkovic V, Jardine MJ, Neal B, et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med 2019; 380: 2295-306. source
The cited paper supplies the CREDENCE result used for the comparison. In “Effect on the Primary Outcome and Renal Components,” it reports a 30% lower relative risk of the primary outcome with canagliflozin than with placebo; the comparison with the citing authors’ trial is their own framing. (LLM, conf=0.90)
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“markedly lower than in trials of dual RAS blockade (4.8% with combination therapy with a direct renin inhibitor and an ACE inhibitor or ARB 20 and 9.2% with dual ACE inhibitor and ARB therapy 22 )”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Least-Squares Mean Ratio to Baseline
What the sources say
- Not checked — no full text of the sourcecites [20] 20. Parving H-H, Brenner BM, McMurray JJV, et al. Cardiorenal end points in a trial of aliskiren for type 2 diabetes. N Engl J Med 2012; 367: 2204-13. source
- Partly supportedcites [22] 22. Imai E, Chan JCN, Ito S, et al. Effects of olmesartan on renal and cardiovascu- lar outcomes in type 2 diabetes with overt nephropathy: a multicentre, randomised, placebo-controlled study. Diabetologia 2011; 54: 2978-86. sourceExperimental — accuracy not yet measured
The Discussion section, “Safety of olmesartan in patients treated with ACEI” (page unavailable), reports hyperkalaemia in 9.2% of the olmesartan group versus 5.3% of the placebo group. It separately says approximately 20% discontinued because of adverse events. It does not identify 9.2% as the rate of discontinuation due to hyperkalaemia or as a rate specifically among patients receiving both an ACE inhibitor and an ARB. (LLM, conf=0.85)
plaincorrelational- Asserted: passes — The authors put it forward as true.
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Every source the paper cites for this claim was checked and supports it.
In the paper
“the CREDENCE trial excluded patients treated with mineralocorticoid receptor antagonists”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Discussion
What the sources say
- Supportedcites [4] 4. Perkovic V, Jardine MJ, Neal B, et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med 2019; 380: 2295-306. source
The Patients section states that treatment with a mineralocorticoid-receptor antagonist was not allowed under the trial’s eligibility criteria. This supports the claim that CREDENCE excluded patients receiving that treatment. (LLM, conf=0.91)
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Preclinical data showed that the kidney and cardiovascular benefits of finerenone were associated with potent antiinflammatory and antifibrotic effects through inhibition of overactivation of the mineralocorticoid receptor.6,[10][11][12][13]23”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Least-Squares Mean Ratio to Baseline
What the sources say
- Not checked — no full text of the sourcecites [6] 6. Barrera-Chimal J, Estrela GR, Lechner SM, et al. The myeloid mineralocorticoid receptor controls inf lammatory and fi- brotic responses after renal injury via mac- rophage interleukin-4 receptor signaling. Kidney Int 2018; 93: 1344-55. source
- Partly supportedcites [10] 10. Grune J, Beyhoff N, Smeir E, et al. Se- lective mineralocorticoid receptor cofactor modulation as molecular basis for finere- none's antifibrotic activity. Hypertension 2018; 71: 599-608. sourceExperimental — accuracy not yet measured
The Abstract reports that finerenone blocked cardiac fibrosis and macrophage invasion in mice, and the Discussion describes its cardiac antifibrotic and anti-inflammatory effects. The paper links these findings to mineralocorticoid receptor modulation, but treats a corresponding mechanism for renal benefit as a possibility rather than demonstrating that kidney benefits arise through those same effects. (LLM, conf=0.86)
- Not checked — no full text of the sourcecites [11] 11. Kolkhof P, Delbeck M, Kretschmer A, et al. Finerenone, a novel selective nonste- roidal mineralocorticoid receptor antago- nist protects from rat cardiorenal injury. J Cardiovasc Pharmacol 2014; 64: 69-78. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“the mechanisms of action differ between drug classes, including different effects on metabolic, hemodynamic, and diuretic factors and on inflammation and fibrosis.4,13,18,19”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Least-Squares Mean Ratio to Baseline
What the sources say
- Partly supportedcites [4] 4. Perkovic V, Jardine MJ, Neal B, et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med 2019; 380: 2295-306. sourceExperimental — accuracy not yet measured
The Discussion says canagliflozin’s benefit may be independent of glucose levels and may stem from reduced intraglomerular pressure. This addresses possible metabolic and hemodynamic mechanisms, but the paper does not compare mechanisms across drug classes or establish differing effects on diuresis, inflammation, and fibrosis. (LLM, conf=0.76)
- Not matchedcites [13] 13. Agarwal R, Kolkhof P, Bakris G, et al. Steroidal and non-steroidal mineralocorti- coid receptor antagonists in cardiorenal medicine. Eur Heart J (in press).
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [18] 18. Heerspink HJ, Perkins BA, Fitchett DH, Husain M, Cherney DZ. Sodium glu- cose cotransporter 2 inhibitors in the treatment of diabetes mellitus: cardiovas- cular and kidney effects, potential mech- anisms, and clinical applications. Circu- lation 2016; 134: 752-72. source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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- Partly supported
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“the number of patients who needed to be treated with finerenone to prevent one key secondary outcome event was 42 (95% CI, 22 to 397).”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Primary and Key Secondary Outcomes
plaindirectn = 420- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The effects of finerenone on the primary outcome were generally consistent across prespecified subgroups (Fig. S3).”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Primary and Key Secondary Outcomes
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Overall, the frequency of adverse events was similar in the two groups.”
- Also stated in: § Safety Outcomes and Vital Signs · plain
“The incidence of adverse events that occurred during the treatment period was similar in the finerenone and placebo groups”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > RESULTS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Safety Outcomes and Vital Signs · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A key secondary outcome event occurred in 367 patients (13.0%) and 420 patients (14.8%) in the respective groups (hazard ratio, 0.86; 95% CI, 0.75 to 0.99; P = 0.03).”
- Also stated in: § Primary and Key Secondary Outcomes · plain
“Patients in the finerenone group also had a significantly lower risk of a key secondary outcome event (death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure), which occurred in 367 patients (13.0%) in the finerenone group and 420 patients (14.8%) in the placebo group (hazard ratio, 0.86; 95% CI, 0.75 to 0.99; P = 0.03)”
- Also stated in: § Discussion · plain
“Patients in the finerenone group also had a lower risk of a key secondary outcome event (death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure).”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > RESULTS
plaindirectn = 367- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Primary and Key Secondary Outcomes · plain
- Probably not a substantial claim. 20
- It may state two separate claims as one. 20
- The quote only partly states this claim. 1
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“To account for multiple testing, the weighted Bonferroni-Holm procedure was used for the primary outcome and the key secondary outcome, followed by a hierarchical testing procedure of additional secondary outcomes, as described previously.16”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Statistical Analysis
What the sources say
- Partly supportedcites [16] 16. Bakris GL, Agarwal R, Anker SD, et al. Design and baseline characteristics of the Finerenone in Reducing Kidney Failure and Disease Progression in Diabetic Kid- ney Disease trial. Am J Nephrol 2019; 50: 333-44. sourceExperimental — accuracy not yet measured
The Statistical Considerations—Statistical Analyses section specifies the weighted Bonferroni-Holm procedure for the primary renal and key secondary cardiovascular endpoints, followed by hierarchical testing of further secondary endpoints. As a design paper, however, it says these procedures “will be used”; it does not establish that they were actually used. (LLM, conf=0.82)
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“hemodynamic effects were also seen in trials of dual RAS blockade that did not show efficacy, [20][21][22] which implicates other mechanisms.”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Least-Squares Mean Ratio to Baseline
What the sources say
- Not checked — no full text of the sourcecites [20] 20. Parving H-H, Brenner BM, McMurray JJV, et al. Cardiorenal end points in a trial of aliskiren for type 2 diabetes. N Engl J Med 2012; 367: 2204-13. source
- Not checked — no full text of the sourcecites [21] 21. Fried LF, Emanuele N, Zhang JH, et al. Combined angiotensin inhibition for the treatment of diabetic nephropathy. N Engl J Med 2013; 369: 1892-903. source
- Supportedcites [22] 22. Imai E, Chan JCN, Ito S, et al. Effects of olmesartan on renal and cardiovascu- lar outcomes in type 2 diabetes with overt nephropathy: a multicentre, randomised, placebo-controlled study. Diabetologia 2011; 54: 2978-86. source
The Discussion reports lower blood pressure during olmesartan treatment, despite no additional benefit on the composite renal outcome. Most participants were also receiving an ACE inhibitor, making this study an example of dual RAS blockade with a hemodynamic effect but no demonstrated renal-outcome benefit. The statement about other mechanisms is the citing authors’ inference, not a finding attributed to this source. (LLM, conf=0.90)
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Previous kidney-outcome trials that involved patients with CKD and type 2 diabetes targeting dual RAS blockade have shown a lack of efficacy and increased risk (including increased incidences of acute kidney injury, hypotension, and hyperkalemia) [20][21][22]”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Least-Squares Mean Ratio to Baseline
What the sources say
- Not checked — no full text of the sourcecites [20] 20. Parving H-H, Brenner BM, McMurray JJV, et al. Cardiorenal end points in a trial of aliskiren for type 2 diabetes. N Engl J Med 2012; 367: 2204-13. source
- Not checked — no full text of the sourcecites [21] 21. Fried LF, Emanuele N, Zhang JH, et al. Combined angiotensin inhibition for the treatment of diabetic nephropathy. N Engl J Med 2013; 369: 1892-903. source
- Partly supportedcites [22] 22. Imai E, Chan JCN, Ito S, et al. Effects of olmesartan on renal and cardiovascu- lar outcomes in type 2 diabetes with overt nephropathy: a multicentre, randomised, placebo-controlled study. Diabetologia 2011; 54: 2978-86. sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The incidences of serum potassium levels of more than 5.5 mmol per liter and more than 6.0 mmol per liter were 21.7% and 4.5%, respectively, in the finerenone group and 9.8% and 1.4%, respectively, in the placebo group.”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Safety Outcomes and Vital Signs
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and a lower mean urinary albumin-to-creatinine ratio with finerenone than with placebo was maintained thereafter (Fig. 3A).”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Other Secondary and Exploratory Outcomes
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Acute kidney injury-related adverse events and serious adverse events were balanced between the two groups (Table 2).”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Safety Outcomes and Vital Signs
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In prespecified “on-treatment” sensitivity analyses that included all events from randomization to 30 days after the last dose of finerenone or placebo, the risk of a primary outcome event and the risk of a key secondary outcome event were both lower by 22% with finerenone than with placebo (Table S4).”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Primary and Key Secondary Outcomes
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The incidences of the components were lower with finerenone than with placebo except for nonfatal stroke, which had a similar incidence in the two groups (Fig. 2).”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Primary and Key Secondary Outcomes
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Glycated hemoglobin levels (Fig. S8) and body weight (Fig. S9) were similar in the two groups.”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Safety Outcomes and Vital Signs
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Patients who received finerenone had a higher mean serum potassium level than those who received placebo; a maximal difference of 0.23 mmol per liter was observed at month 4, and the difference remained largely stable thereafter (Fig. 3B).”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Safety Outcomes and Vital Signs
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In a patient population with multiple coexisting conditions and advanced CKD (almost 55% of the patients had a baseline eGFR of <45 ml per minute per 1.73 m 2 ) who were at high risk for kidney and cardiovascular events, the benefits of finerenone were observed after 12 months for the kidney outcome and as early as 1 month for the cardiovascular outcome, and these benefits persisted throughout the”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Rests on an assumption: Patients with CKD and type 2 diabetes and advanced CKD are at high risk for kidney and cardiovascular events.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In our trial involving patients with type 2 diabetes and advanced CKD, finerenone resulted in lower risks of CKD progression and cardiovascular events than placebo.”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Least-Squares Mean Ratio to Baseline
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“modest blood-pressure reduction (in the absence of effects on glycated hemoglobin levels and body weight)”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Least-Squares Mean Ratio to Baseline
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“This event-driven trial was designed to have 90% power to detect a 20% lower risk of a primary outcome event with finerenone than with placebo, on the basis of 1068 patients with a primary outcome event.”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Statistical Analysis
plaindirectn = 1,068- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Safety analyses were performed in the safety analysis set (all randomly assigned patients without critical Good Clinical Practice violations who received at least one dose of finerenone or placebo).”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > 2222
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Efficacy analyses were performed in the full analysis set (all randomly assigned patients without critical Good Clinical Practice violations).”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Statistical Analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The mean adherence to the trial regimen (the percentage of administered doses relative to the number of planned doses) was 92.1% in the finerenone group and 92.6% in the placebo group”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Patients
plainn = 5,674- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Because of the formal interim analysis, significance levels for the multipletesting procedure in the final analysis were adjusted from 1.6667%, 3.3333%, and 5% to 1.5762%, 3.2827%, and 4.9674%, respectively.”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Statistical Analysis
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In time-to-event analyses, the superiority of finerenone over placebo was tested by means of a stratified log-rank test; stratification factors were geographic region (North America, Latin America, Europe, Asia, or other), eGFR category (25 to <45, 45 to <60, or ≥60 ml per minute per 1.73 m 2 ) at screening, and albuminuria category (moderately or severely elevated) at screening.”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Statistical Analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Our trial was a phase 3, randomized, doubleblind, placebo-controlled, multicenter clinical trial.”
- Also stated in: § METHODS · plain
“In this double-blind trial, we randomly assigned 5734 patients with CKD and type 2 diabetes in a 1:1 ratio to receive finerenone or placebo.”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Effect of Finerenone on Chronic Kidney
plainn = 5,734- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Also stated in: § METHODS · plain
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“At the trial conclusion, after a median followup of 2.6 years, 822 patients (29.0%) in the finerenone group and 801 patients (28.2%) in the placebo group had discontinued the trial regimen”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Patients
plainn = 822- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The observed benefits of finerenone were clinically significant and were obtained on a background of guideline-directed therapy, including RAS blockade at a maximum labeled dose that did not cause unacceptable side effects plus well-controlled glycated hemoglobin and bloodpressure levels.”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A clinical event committee whose members were unaware of the trial-group assignments independently reviewed and adjudicated all reported outcome events.”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Outcomes
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“an independent data monitoring committee con-ducted one planned interim efficacy analysis and oversaw patient safety.”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Effect of Finerenone on Chronic Kidney
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“the mean daily dose was 15.1 mg and 16.5 mg in the respective groups.”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Patients
plainn = 5,674- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A total of 98.1% and 98.8% of the patients were treated with an ACE inhibitor or ARB, respectively, at a maximum labeled dose that did not cause unacceptable side effects (Table S2).”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Patients
plainn = 5,674- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“vital status was ascertained for all but 18 patients (5656 patients [99.7%])”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Patients
plainn = 5,656- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Owing to critical Good Clinical Practice violations (including violations that led to the closure of one site and other violations related to patient misconduct), 60 patients were prospectively excluded from all analyses (further details are provided in the Supplementary Appendix), leaving 5674 patients who were included in the statistical analyses.”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Patients
plainn = 5,674- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“All eGFR outcome events required confirmation with a second consecutive central laboratory measurement at least 4 weeks after the initial measurement.”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Outcomes
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Baseline characteristics and concomitant medications were balanced between the two groups (Table 1 and Table S1).”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Patients
plainn = 5,674- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The trial was performed in accordance with the principles of the Declaration of Helsinki.”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Effect of Finerenone on Chronic Kidney
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“we excluded patients with nonalbuminuric CKD and CKD not due to type 2 diabetes”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Least-Squares Mean Ratio to Baseline
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These factors may restrict the generalizability of the findings.”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Least-Squares Mean Ratio to Baseline
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“the present trial had no protocol recommendations to restrict dietary potassium or potassium supplements, including in patients with hyperkalemia”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Least-Squares Mean Ratio to Baseline
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“our trial allowed SGLT2 inhibitor treatment”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“our trial had a run-in period that allowed background medical therapies to be adjusted, including adjustment of ACE inhibitor or ARB therapy to a maximum labeled dose that did not cause unacceptable side effects.”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
The long-term effects of finerenone on kidney and cardiovascular outcomes in patients with CKD and type 2 diabetes are unknown.
“However, its long-term effects on kidney and cardiovascular outcomes are unknown.”
The paper relies on this without support.
Finerenone reduced albuminuria in short-term trials.
“Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials”
The paper relies on this without support.
Patients with CKD and type 2 diabetes and advanced CKD are at high risk for kidney and cardiovascular events.
“who were at high risk for kidney and cardiovascular events”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“It is also noteworthy that the nonsteroidal mineralocorticoid receptor antagonists (MRAs) do not increase the risk of AKI when used to slow kidney disease progression (33).”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [33]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The FIDELIO-DKD trial included participants with (i) eGFR 25 -60 ml/min per 1.73 m 2 , ACR 30 -< 300 mg/g [3 -< 30 mg/mmol], and diabetic retinopathy or (ii) ACR 300 -5000 mg/g [30 -500 mg/mmol] and eGFR 25 -75 ml/min per 1.73 m 2”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [162]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“and no effect on HbA1c, no increase in hypo- or hyperglycemia, and no sexual side effects due to the speci fi city for the MRA.”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [162]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“and fi nerenone reduced the risk of kidney and cardiovascular outcomes in 2 pivotal outcome trials.”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [162]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Patients with T2D and albuminuria are known to be at high risk of CKD progression and cardiovascular events, and the FIDELIO-DKD and FIGARO-DKD trials demonstrated that fi nerenone reduced these events (particularly CKD progression and heart failure) among such patients.”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [162]
Experimental — accuracy not yet measured
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In FIGARO-DKD, finerenone significantly reduced the primary cardiovascular composite outcome risk in a broader patient population than studied in FIDELIO-DKD (patients with stage 2–4 CKD and moderately increased albuminuria, or stage 1–2 CKD with severely increased albuminuria).7 , 10”
From Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis (2022) · cites this paper as [7]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The pooled analysis of two complementary trials comprising 13 026 patients with a broad spectrum of CKD and type 2 diabetes, all treated with an optimized dose of an ACEi or ARB,7 , 10 provides robust evidence of both cardiovascular and kidney protection with finerenone vs. placebo.”
From Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis (2022) · cites this paper as [7]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Nonsteroidal mineralocorticoid receptor antagonists (nsMRAs) do not increase the risk of AKI when used to slow kidney disease progression (33).”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [33]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“A prespecified secondary outcome was death from cardiovascular causes, nonfatal MI, nonfatal stroke, or hospitalization for heart failure, which was reduced by 13% in the finerenone group.”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [285]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Finerenone was investigated in two complementary phase 3 studies of patients with T2D, kidney disease (defined primarily as ACR ≥30 mg/g), and potassium <4.8 mmol/L and is the only ns-MRA approved in the world for slowing CKD progression and reducing cardiovascular events.”
From Diabetes management in chronic kidney disease: a consensus report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) (2022) · cites this paper as [86]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Serum potassium was monitored regularly, and 2.6% of participants stopped treatment because of hyperkalemia with finerenone compared with 0.9% on placebo (86).”
From Diabetes management in chronic kidney disease: a consensus report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) (2022) · cites this paper as [86]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In summary, FIDELIO-DKD and FIGARO-DKD demonstrated cardiovascular and kidney benefits for finerenone among people with T2D who were treated with standard of care (including an RAS inhibitor at maximally tolerated doses and good control of glycemia and BP) who were at high residual risk, based largely on albuminuria (ACR ≥30 mg/g).”
From Diabetes management in chronic kidney disease: a consensus report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) (2022) · cites this paper as [86]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“In patients with diabetic kidney disease with increased levels of albuminuria, large placebo-controlled trials have shown that renin-angiotensin system (RAS) inhibitors,3–5 sodium-glucose cotransporter 2 (SGLT2) inhibitors,6,7 and the non-steroidal mineralocorticoid receptor antagonist finerenone8,9 all reduced the risk of progression to kidney failure.”
From Empagliflozin in Patients with Chronic Kidney Disease (2023) · cites this paper as [8]
The cited source says what the claim attributes to it.
In the citing paper
“The primary end point was reduced with finerenone compared with placebo (HR 0.82 [95% CI 0.73-0.93];P = 0.001)”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [33]
The cited source says what the claim attributes to it.
In the citing paper
“However, the study was completed, and there were no deaths related to hyperkalemia.”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [33]
The cited source says what the claim attributes to it.
In the citing paper
“as was the key secondary composite of cardiovascular outcomes (HR 0.86 [95% CI 0.75-0.99];P = 0.03).”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [33]
The cited source says what the claim attributes to it.
In the citing paper
“Late in 2020, the results of the first of two trials, the Finerenone in Reducing Kidney Failure and Disease Progression in Diabetic Kidney Disease (FIDELIO-DKD) trial, which examined the kidney effects of finerenone, demonstrated a significant reduction in CKD progression and cardiovascular events in people with diabetes and advanced CKD (33,125).”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [33]
The cited source says what the claim attributes to it.
In the citing paper
“Hyperkalemia resulted in 2.3% discontinuation in the study group compared with 0.9% in the placebo group.”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [33]
The cited source says what the claim attributes to it.
In the citing paper
“SGLT2 inhibitors and finerenone, a nonsteroidal mineralocorticoid receptor antagonist, also reduce albuminuria in clinical trials of advanced diabetic kidney disease (471-473).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [473]
The cited source says what the claim attributes to it.
In the citing paper
“There was an 18% lower incidence of primary composite outcome that included kidney failure, sustained decrease of 40% decline in eGFR, or death from kidney causes with the use of fi nerenone.”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [162]
The cited source says what the claim attributes to it.
In the citing paper
“All participants were treated with a RASi, titrated to the maximum antihypertensive or maximum tolerated dose.”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [162]
The cited source says what the claim attributes to it.
In the citing paper
“On average, there was only a small reduction in systolic blood pressure (3 mm Hg) with fi nerenone compared to placebo, and no effect on HbA1c, no increase in hypo- or hyperglycemia, and no sexual side effects due to the speci fi city for the MRA.”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [162]
The cited source says what the claim attributes to it.
In the citing paper
“The FIDELIO-DKD trial was designed to detect a treatment effect of finerenone on kidney failure endpoints, whereas the FIGARO-DKD trial aimed to detect an effect on a cardiovascular composite primary endpoint.7 , 10”
From Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis (2022) · cites this paper as [7]
The cited source says what the claim attributes to it.
In the citing paper
“In FIDELIO-DKD, finerenone significantly reduced the risk of the primary kidney composite outcome and the key secondary cardiovascular composite outcome in patients with predominantly stage 3–4 CKD with severely increased albuminuria and type 2 diabetes.7”
From Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis (2022) · cites this paper as [7]
The cited source says what the claim attributes to it.
In the citing paper
“Hyperkalemia resulted in 2.3% discontinuation in the study group compared with 0.9% in the placebo group.”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [33]
The cited source says what the claim attributes to it.
In the citing paper
“the Finerenone in Reducing Kidney Failure and Disease Progression in Diabetic Kidney Disease (FIDELIO-DKD) trial, which examined the kidney effects of finerenone, an nsMRA, demonstrated a significant reduction in CKD progression and cardiovascular events in people with diabetes and advanced CKD (33,143).”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [33]
The cited source says what the claim attributes to it.
In the citing paper
“as was the key secondary composite of cardiovascular outcomes (HR 0.86 [95% CI 0.75-0.99];P = 0.03).”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [33]
The cited source says what the claim attributes to it.
In the citing paper
“The primary end point was reduced with finerenone compared with placebo (HR 0.82 [95% CI 0.73-0.93];P = 0.001)”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [33]
The cited source says what the claim attributes to it.
In the citing paper
“A prespecified secondary outcome was death from cardiovascular causes, nonfatal MI, nonfatal stroke, or hospitalization for heart failure, which was reduced by 13% in the finerenone group.”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [285]
The cited source says what the claim attributes to it.
In the citing paper
“The incidence of heart failure hospitalization occurred less in the finerenone-treated group, and only 7.7% of study participants had a prior history of heart failure.”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [285]
The cited source says what the claim attributes to it.
In the citing paper
“The incidence of heart failure hospitalization occurred less in the finerenone-treated group, and only 7.7% of study participants had a prior history of heart failure.”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [285]
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Overall, the updated evidence review identifi ed 27 RCTs on MRA, with 5 RCTs comparing nonsteroidal MRA to placebo and/or standard of care.”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [162]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Compared with patients with advanced kidney disease, who are more likely to progress to dialysis, patients with better preserved estimated glomerular filtration rate (eGFR) have a greater lifetime risk of cardiovascular morbidity such as heart failure, myocardial infarction (MI), stroke, or dying from cardiovascular causes.7”
From Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis (2022) · cites this paper as [7]
Experimental — accuracy not yet measuredIn the citing paper
“Despite the fact that clinical trials have demonstrated the efficacy of these lifestyle and pharmacological interventions (3–10), residual cardiovascular (CV) and kidney risk remains present even with guideline-recommended treatment (8,10).”
In the citing paper
“According to two large randomized placebo-controlled trials targeted at T2DM and CKD patients, finerenone has been demonstrated to significantly reduce the occurrences of composite renal outcome”
In the citing paper
“and composite cardiovascular outcome (defined as a composite of nonfatal MI, nonfatal stroke, death from cardiovascular causes, or hospitalization for heart failure [HHF]), regardless of patients with or without established cardiovascular disease [16, 17].”
In the citing paper
“The DAPA-CKD and FIDELIO trials enrolled patients with eGFR ≥25 mL/min/1.73 m2 and the EMPA-KIDNEY trial enrolled patients with eGFR ≥20 mL/min/1.73 m2; results demonstrated that dapagliflozin, finerenone and empagliflozin are effective and safe in these patients, although safety data are lacking for initiating therapy below these thresholds [16,17,22].”
From Glucagon-like peptide-1 receptor agonists in diabetic kidney disease: a review of their kidney and heart protection (2023) · cites this paper as [22]
In the citing paper
“Even more recently, the non-steroidal mineralocorticoid receptor antagonist (MRA) finerenone has been shown to confer both cardiovascular and kidney protection in patients with T2D and CKD, in both a dedicated kidney outcome trial and a dedicated cardiovascular outcome trial [22,23].”
From Glucagon-like peptide-1 receptor agonists in diabetic kidney disease: a review of their kidney and heart protection (2023) · cites this paper as [22]
In the citing paper
“FIDELIO-DKD and FIGARO-DKD each enrolled people with T2D treated with the maximum-tolerated dose of RASi who had residual albuminuria (ACR $30 mg/g [$3 mg/mmol]) and a nonelevated serum potassium (<4.8 mEq/l at screening).”
In the citing paper
“In FIDELIO-DKD, finerenone significantly reduced the incidence of both the primary composite kidney outcome (kidney failure, sustained decrease $40% in eGFR, or death from kidney causes; hazard ratio [HR]: 0.82, 95% confidence interval [CI]: 0.73-0.93)and the secondary composite cardiovascular outcome (death from cardiovascular causes, nonfatal MI, nonfatal stroke, or hospitalization for heart f”
In the citing paper
“To mitigate hyperkalemia risk, the FIDELIO-DKD and FIGARO-DKD trials restricted eligibility to patients with non-elevated serum potassium concentration (after maximizing RASi) and implemented a standardized potassiummonitoring protocol.”
In the citing paper
“This recommendation is based on the high-quality evidence from FIDELIO-DKD and FIGARO-DKD (Grade A, summarized above) that finerenone slows progression of CKD and reduces risks of cardiovascular events in this population.25,26”
In the citing paper
“Two large clinical trials (Finerenone in Reducing Kidney Failure and Disease Progression in Diabetic Kidney Disease [FIDELIO-DKD] 25 and Finerenone in Reducing Cardiovascular Mortality and Morbidity in Diabetic Kidney Disease [FIGARO-DKD] 26 ) and a pre-specified individual-level combined analysis of these 2 trials (The FInerenone in chronic kiDney diseasE and type 2 diabetes: Combined FIDELIO-DKD”
In the citing paper
“The placebo-controlled FIDELIO-DKD (Efficacy and Safety of Finerenone in Subjects With Type 2 Diabetes Mellitus and Diabetic Kidney Disease) and FIGARO-DKD (Efficacy and Safety of Finerenone in Subjects With Type 2 Diabetes Mellitus and the Clinical Diagnosis of Diabetic Kidney Disease) trials demonstrated for the non-steroidal MRA finerenone that these effects translate into reduced risk of kid”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [720]
In the citing paper
“Finerenone, a selective nonsteroidal mineralocorticoid antagonist, has been shown in the Finerenone in Reducing Kidney Failure and Disease Progression in Diabetic Kidney Disease (FIDELIO-DKD) trial to improve CKD outcomes in people with type 2 diabetes with stage 3 or 4 CKD and severe albuminuria (233).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2023 (2023) · cites this paper as [233]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > METHODS
“All the patients were treated with renin-angiotensin system blockade that had been adjusted before randomization to the maximum dose on the manufacturer's label that did not cause unacceptable side effects.”
§ Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials > Other Secondary and Exploratory Outcomes
“A total of 14 patients were not treated with either an ACE inhibitor or an angiotensin-receptor blocker at baseline”
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Diabetic Kidney Disease: Increasing Hope with Transformative Therapies
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Metadata
- Authors
- Bakris, G. L., Agarwal, R., Anker, S. D., Pitt, B., Ruilope, L. M., Rossing, P., Kolkhof, P., Nowack, C., Schloemer, P., Joseph, A., & Filippatos, G.
- Affiliations
- University of Chicago (US)
- University of Michigan (US)
- University of Copenhagen (DK)
- National and Kapodistrian University of Athens (GR)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2020-12-03
- Volume
- 383
- Issue
- 23
- Pages
- 2219-2229
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W3094429645
- Semantic Scholar
- 44a8071f04b73823b399c19107ce7654773ab880
- Cited by
- 2,935
- References
- 27
- Citations by year
- 2026: 661 · 2025: 603 · 2024: 504 · 2023: 464 · 2022: 400 · 2021: 284 · 2020: 17
- FWCI
- 182.72
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
- ABACUS. Repositorio de Producción Científica (Universidad Europea) (submittedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion)
- Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (submittedVersion, public-domain)
- UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Open Access CRIS of the University of Bern
- Funders
- Bayer
- Topics
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
- Keywords
- finerenone, chronic kidney disease, type 2 diabetes, mineralocorticoid receptor antagonists, renal failure, cardiovascular events, hyperkalemia, renin-angiotensin system blockade, FIDELIO-DKD, albuminuria
- MeSH terms
- Aged, Albuminuria, Creatinine, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Double-Blind Method, Female, Glomerular Filtration Rate, Humans, Hyperkalemia, Male, Naphthyridines, Treatment Outcome, Renal Insufficiency, Chronic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-16, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-16 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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