To the Editor Dr Bakris and colleagues1 evaluated the safety and efficacy of dual blockade of the renin-angiotensin-aldosterone system by adding the nonsteroidal mineralocorticoid receptor antagonist (MRA) finerenone to an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin receptor blocker in patients with diabetic nephropathy. The authors stated that the addition of finerenone resulted in improvement in the urinary albumin-creatinine ratio (UACR) compared with placebo. We have a number of concerns about the study.
Feng Y, Zeng X, Fu P. Finerenone for Albuminuria in Patients With Diabetic Nephropathy. JAMA. 2016;315(3):305-306. doi:10.1001/jama.2015.15996