Effects of Finerenone on Vascular Stiffness and Cardiorenal Biomarkers in T2D and CKD (FIVE-STAR) (FIVE-STAR)

Inclusion Criteria: Patients who have given their written consent to participate in this study Patients who are 20 years of age or older at the time of consent (regardless of gender) Patients with type 2 diabetes mellitus Patients with chronic kidney disease who meet both of the following criteria; i) eGFR greater than 25 mL/min/1.73 m2 and less than 90 mL/min/1.73 m2, ii) UACR greater than 30 mg/g.cr. and less than 3500 mg/g.cr. Patients who have not changed their medications for type 2 diabetes and chronic kidney disease in the past 4 weeks prior to obtaining consent Exclusion Criteria: Patients who are currently taking or have taken MRAs containing finerenone in the past 4 weeks prior to obtaining consent. Patients with a history of hypersensitivity to finerenone Patients with HbA1c greater than 10%. Patients with a serum potassium level of 4.9 mEq/L or higher Patients with NYHA class II-IV HFrEF (LVEF <35%) Patients with poorly controlled hypertension (e.g., systolic BP >170 mmHg, diastolic BP >110 mmHg, or hypertensive emergencies) Patients with a history of ischemic stroke, acute coronary syndrome, cardiovascular surgery or percutaneous intervention, or hospitalization for worsening heart or renal failure in the past 8 weeks prior to obtaining consent Patients with a preplanned surgical or percutaneous intervention for coronary artery reconstruction or other cardiovascular disease during the individual observation period. Patients with a preplanned treatment such as electrical cardioversion, cardiac resynchronization therapy or pacemaker implantation during the individual observation period. Patients with preplanned dialysis or kidney transplantation during the individual observation period. Patients with severe hepatic dysfunction (Child-Pugh Class C) Patients receiving itraconazole, ritonavir-containing products, atazanavir, darunavir, fosamprenavir, cobicistat-containing products, or clarithromycin Patients with Addison's disease Patients with active infectious diseases Pregnant, possibly pregnant, or lactating patients Other patients deemed inappropriate for this study by the principal investigator or subinvestigators (e.g., patients with renal artery stenosis, one kidney, or active malignancy).