Living with type 2 diabetes often means managing not just blood sugar, but also its effects on other organs, especially the kidneys and heart. Over time, diabetes can damage blood vessels and filtering units in the kidneys, leading to chronic kidney disease (CKD). Kerendia (finerenone) is a newer medication developed to help slow down this damage and protect both kidney and heart health.

Kerendia is a nonsteroidal mineralocorticoid receptor antagonist (MRA), a targeted drug class that works differently from traditional diuretics or blood pressure medicines. It was approved by the U.S. Food and Drug Administration (FDA) in 2021, marking a significant step forward in the treatment of diabetic kidney disease.

By addressing inflammation and scarring inside the kidneys, Kerendia helps patients with chronic kidney disease associated with type 2 diabetes maintain better long-term health and reduce the risk of heart-related complications.

What does Kerendia do?

Kerendia is prescribed for adults with chronic kidney disease (CKD) related to type 2 diabetes. It is not a blood sugar–lowering drug but works alongside standard diabetes and kidney medications, such as ACE inhibitors, ARBs, or SGLT2 inhibitors, to offer extra protection.

Its main goals are to slow kidney disease progression, lower the risk of kidney failure or dialysis, and reduce the risk of heart attacks, strokes, and heart failure hospitalizations.

Clinical studies, including the large FIDELIO-DKD and FIGARO-DKD trials, showed that patients taking Kerendia had significantly lower rates of kidney function decline and fewer cardiovascular events compared to those on placebo (Bakris et al., 2020).

Kerendia prolongs kidney health and reduces heart strain in diabetic kidney disease, improving both life expectancy and quality of life.

How does Kerendia work?

Kerendia works by blocking the effects of the hormone aldosterone on certain receptors in the kidneys, heart, and blood vessels. Aldosterone normally helps regulate salt and water balance, but when its levels are too high, as often happens in diabetes and kidney disease, it can cause inflammation and scarring in these organs.

Kerendia blocks a harmful hormone to reduce kidney inflammation and scarring, lower protein loss in urine, and improve heart and vascular health.

Unlike older steroidal MRAs (like spironolactone), finerenone is nonsteroidal, meaning it is less likely to cause hormonal side effects such as breast tenderness or hormonal imbalances.

Clinically, this mechanism is important because it targets a root cause of diabetic kidney injury, not just its symptoms. That makes Kerendia part of a modern, mechanism-driven approach to slowing disease progression rather than only treating complications as they appear (FDA, 2021).

Kerendia side effects

Kerendia is generally well-tolerated, but because it affects mineral balance in the body, the main concern is elevated potassium levels (hyperkalemia).

Common side effects include:

• Mild increases in blood potassium
• Low blood pressure (hypotension)
• Dizziness or fatigue

Less common or serious side effects:

• Significant hyperkalemia (which may cause muscle weakness or irregular heartbeat)
• Worsening kidney function in some patients

Your doctor will check your blood potassium and kidney function regularly especially when starting or adjusting your dose, to ensure Kerendia remains safe and effective.

You should not take Kerendia if you:

• Have high potassium levels before starting treatment
• Have severe kidney impairment
• Are taking other medications that increase potassium, such as certain diuretics or supplements, unless your doctor advises otherwise

If you experience symptoms like muscle weakness, chest pain, or an unusually slow heartbeat, seek medical attention promptly.

Kerendia dosage

Kerendia comes in tablet form and is taken once daily, with or without food. The exact dosage depends on your kidney function and blood potassium levels.

Before and during Kerendia treatment, blood tests will monitor serum potassium and eGFR (kidney function) to guide dose adjustments for safe potassium levels.

Doctors may also review your other medications to prevent interactions, especially with drugs that affect potassium or kidney function.

Kerendia is typically added to a regimen that already includes standard-of-care medications like ACE inhibitors or ARBs, not as a replacement.

For older adults or those with multiple medical conditions, close monitoring ensures that the benefits of kidney and heart protection outweigh any potential risks.

Does Kerendia have a generic version?

As of 2025, Kerendia (finerenone) does not have an FDA-approved generic version. It is currently available only as the brand-name product made by Bayer. However, international versions may exist in other markets.

Since it’s a relatively new medication with patent protection, generic alternatives are not yet on the market. However, many insurance plans offer coverage or co-pay assistance for Kerendia, and patient support programs are available through the manufacturer.

When generics do become available in the future, they will be required by the FDA to have the same active ingredient, strength, and therapeutic effect as Kerendia, ensuring equal safety and efficacy.

Conclusion

Kerendia represents an important advancement for people living with type 2 diabetes and chronic kidney disease. By targeting the underlying processes that cause kidney and heart damage, it offers patients a way to slow disease progression and reduce serious complications that affect longevity and quality of life. Kerendia supplements diabetes/blood pressure medications, providing additional protection without being a cure or replacement.

Regular follow-ups and blood monitoring are essential, but when used under the supervision of a qualified healthcare provider, Kerendia is a safe and effective therapy that supports both kidney and heart health over the long term.

References

1. Bakris, G. L., et al. (2020). Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes (FIDELIO-DKD). New England Journal of Medicine. https://www.nejm.org/
2. U.S. Food and Drug Administration (FDA). (2021). FDA approves Kerendia (finerenone) for patients with chronic kidney disease associated with type 2 diabetes. https://www.fda.gov/
3. Mayo Clinic. (2024). Finerenone (oral route): Uses, side effects, and precautions. https://www.mayoclinic.org/
4. MedlinePlus. (2024). Finerenone oral: Drug information. https://medlineplus.gov/