This article provides an update on pharmacotherapy for diabetic nephropathy. ACE inhibitor or angiotensin 2 receptor blocker therapy is a standard of care for hypertension management in people with diabetes and albuminuria. Additionally, recent trials have elucidated the roles of additional therapeutic agents, including the sodium–glucose cotransporter 2 inhibitors, glucagon-like peptide 1 receptor agonists, and the recently approved mineralocorticoid receptor antagonist finerenone, in the treatment of chronic kidney disease in people with type 2 diabetes. This article provides an evidence-based review of therapies that may delay the progression of kidney disease in this population, including discussion of recent outcomes trials.

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