In patients with type 2 diabetes and albuminuric CKD already on ACEi/ARB, are you initiating finerenone over spironolactone in the primary care setting?

There is a lot of activity in this space. Beyond ACE/ARB, I would opt for SGLT2i over mineralocorticoid receptor antagonist (MRA) or non-steroidal mineral corticoid antagonist (NSMA) given the benefit for cardiovascular disease outcome in addition to CKD. The major question is, “What about GLP-1s?”