FDA Approves Finerenone for Type 1 Diabetes and Kidney Disease

In September 2026, the FDA approved finerenone (brand name Kerendia) to reduce kidney damage in adults with chronic kidney disease (CKD) associated with type 1 diabetes. This approval is significant because it represents the first new treatment option in three decades specifically for kidney disease in the type 1 diabetes community.

Kidney disease is a serious long-term complication that develops in many people with type 1 diabetes over their lifetime. High blood sugar levels, common in type 1 diabetes, can damage the tiny filtering units in the kidneys and lead to progressive kidney dysfunction.

Finerenone works by blocking the effects of a hormone called aldosterone. In people with chronic kidney disease, aldosterone becomes overactive and contributes to kidney damage through oxidative stress, inflammation, and scarring.

By blocking mineralocorticoid receptors—the proteins that aldosterone activates—finerenone protects the kidneys from further damage. The medication is a once-daily pill, making it convenient for people managing type 1 diabetes alongside other treatments.

Finerenone has been available since 2021 for kidney disease in type 2 diabetes and was approved for certain heart failure patients in July 2025. The type 1 diabetes approval expands its use to another population at risk for kidney complications.

The evidence for finerenone in type 1 diabetes comes from Bayer's global FINE-ONE phase 3 clinical trial. The study achieved its primary goal: finerenone significantly reduced a key measure of kidney damage called urinary albumin-to-creatinine ratio (UACR) compared to placebo. These findings were published in The New England Journal of Medicine.

UACR is an important indicator—it measures protein in the urine, which signals kidney damage. Lower UACR levels are associated with better long-term kidney health outcomes. Based on evidence from people with type 2 diabetes, reductions in UACR from finerenone likely indicate lower risk of kidney failure and heart-related complications in people with type 1 diabetes.

A smaller preliminary study following 23 patients with type 1 diabetes and kidney disease for six months found that kidney function remained stable in those taking finerenone, while it declined in those not taking the medication. However, researchers noted that larger, longer-term studies are needed to confirm these findings.

In clinical trials, finerenone was well-tolerated with no new safety issues reported. Researchers monitored for serious side effects such as hyperkalemia (dangerously high potassium levels) and acute kidney injury, neither of which occurred in the study participants.

This approval opens a new treatment option for people with type 1 diabetes who develop chronic kidney disease. It is important to remember that finerenone is a tool to slow kidney damage progression—not a cure for kidney disease. People taking finerenone should continue managing their blood sugar levels, blood pressure, and other aspects of their health with their healthcare team.

Origin: breakthrought1d.org (News report). Evidence: News report, corroborated with 4 indexed studies. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.