Chronic kidney disease, Type 2 diabetes mellitus

Inclusion criteria
• Minimum of 12 months continuous enrolment before the index date in the database with medical and pharmacy coverage measured as continuously receiving medical care from health providers contributing to the electronic health record system
• No recorded prescription of finerenone prior to the index date
• Age 18 years or older as of the index date
• Diabetic kidney disease diagnosis by diagnosis texts at any point before (and including) the index date,
OR
• T2D diagnosis at any point before (and including) the index date using the same algorithms as in previous studies of the FIRST program, AND
o CKD stages 2-4 related to eligibility will be defined according to the presence of the following criteria at any point before (and including) the index date:
o A diagnosis code/text indicating CKD stage 2, 3, 4, or stage unspecified
OR
• Two UACR test results ≥30 mg/g separated by at least 90 days and no more than 548 days.
OR
• Two different eGFR test results ≥15 mL/min/1.73 m2 AND <60 mL/min/1.73 m2 separated by at least 90 days and no more than 548 days.

Exclusion criteria
• Type 1 diabetes mellitus identified by diagnosis codes/texts in the patient record on or before the index date
• Kidney cancer identified by diagnosis codes/texts on or before the index date
• Kidney failure on or before the index date, defined as:
o Two different eGFR test results <15 mL/min/1.73 m2 separated by at least 90 days and no more than 548 days
OR
o Dependence on dialysis (at least 3 sessions over at least 90 days during the baseline period)
OR
o A diagnosis code/text indicating kidney failure or CKD stage 5
OR
o A recorded diagnosis indicating kidney transplant