Do you add a potassium binder to continue finerenone when hyperkalemia develops in a patient with CKD and type 1 diabetes?

I would probably, if there is a significant reduction in proteinuria without a negative impact on eGFR.

Binders can be given, but this would generally be after more conservative interventions around diet, diuretics, and glycemic optimization. Nevertheless, if the potassium remains elevated, generally 5.5 and above, despite these other changes, then a binder is very reasonable.

In general, I do not recommend adding a new agent to counteract the side effects of another agent. Adding the second medication only makes sense in clinically dire situations with no alternative to treatment, as is seen in the oncology world. I do not think there is sufficient evidence of long-term ...