This is an observational study in which data from people with chronic kidney disease (CKD) and type 2 diabetes (T2D) who will be receiving finerenone are collected and studied.

Chronic kidney disease is a long-term condition where the kidneys gradually lose their ability to filter waste and extra water from the blood. Type 2 diabetes occurs when the body does not produce enough insulin or does not use it effectively, leading to high blood sugar levels that can harm the kidneys. As a result, CKD can develop as a complication of T2D.

The study drug, finerenone, is already approved for doctors to prescribe to patients with CKD and T2D.

Finerenone is a medication that works by blocking certain proteins known as mineralocorticoid receptors. An increased stimulation of these proteins is thought to damage the kidneys and the heart. By lowering their stimulation, finerenone reduces the risk of kidney disease progressively getting worse.

The main purpose of this study is to learn more about characteristics and treatment patterns of people with CKD and T2D who have recently started or will start finerenone treatment as prescribed by their doctor as part of their routine medical care in South Korea.

The FINE-REAL Korea study is designed to collect additional data on people with CKD and T2D who are treated with finerenone according to the approved product information, and it will work alongside the original FINE-REAL study (NCT05348733) to gather enough information for safety assessments in Korean population.

To achieve this, researchers will collect data on:

• Clinical characteristics of participants, including their medical history related to CKD and T2D, blood pressure, and heart health.
• Reasons for starting finerenone.
• Reasons for stopping finerenone early.
• The planned and actual duration of finerenone treatment.
• The dosing of finerenone.
• Other medications taken alongside finerenone.

The study will also monitor any medical problems (known as adverse events) that participants may experience during the study. All adverse events will be recorded, regardless of whether they are related to the treatment.

One specific concern is hyperkalemia, which refers to high potassium levels in the blood. This condition can occur when finerenone is used with certain blood pressure medications. Researchers want to understand how often hyperkalemia happens and whether it leads to:

• Early discontinuation of finerenone treatment.
• The need for dialysis, a procedure that filters waste from the blood.
• Hospitalization for care.

Data for this study will be collected from medical records and through interviews conducted by study doctors during routine medical visits.

Participants will be involved in the study for up to 12 months, although this duration may be shorter if their finerenone treatment is stopped early.

Inclusion Criteria:

• Adult female or male participant - All genders (≥18 years old)
• Diagnosis of CKD associated with T2D based on assessment by physician
• Treatment according to local marketing authorization, finerenone 20 or 10 mg. Treatment should have been started up to 8 weeks before or after the ICF is signed.
• Decision to initiate treatment with finerenone must be made before ICF is signed

Exclusion Criteria:

• Participation in an investigational trial at any time during the course of this study
• Contra-indications according to the local label

Participants with a diagnosed of CKD and T2D will be enrolled after the decision for treatment with finerenone has been made by the treating physician.

Currently, there is no established plan for the sharing of Individual Patient Data (IPD) from this study. The availability of this study's data will later be determined according to Bayer's commitment to the EFPIA/PhRMA 'Principles for responsible clinical trial data sharing.' This pertains to the scope, timepoint, and process of data access. As such, Bayer commits to considering requests from qualified researchers for patient- / study-level clinical trial data, and documents from clinical trials involving medicines and indications approved in the US and EU. However, this commitment does not reflect an active IPD sharing plan. This applies to data on new medicines and indications that have been approved by the EU and US regulatory agencies on or after January 01, 2014. Researchers can use www.vivli.org to request access to IPD and documents from clinical studies to conduct research. Information on Bayer's criteria for listing studies is provided in the member section of the portal.