Effect of Treatment With Finerenone on Cardio-Renal Target Organ Damage in Patients With Type 2 Diabetes.

Inclusion Criteria: * Age above 18 years. * Diagnosis of type 2 diabetes according to the World Health Organization definition. * Current treatment with a SGLT2-I1 at maximally tolerated dose. * Current treatment with an ACE inhibitor or an ARB1 at maximally tolerated dose. * Plasma potassium level of 4.8 mmol/L or less at the time of screening. * CKD defined as eGFR ≥25 ml/min/1.73 m2 and albuminuria (UACR between 30-5000 mg/g). * Speak and understand Danish fluently. Exclusion Criteria: * Inability to give informed consent. * Severe renal disease with eGFR \<25 ml/min/1.73m2. * Severe hepatic disease (plasma ALAT above 3 x upper limit of normal). * Active cancer diagnosis other than basal cell carcinoma. * Treatment with systemic steroids at time of randomization. * Bariatric surgery within 2 years or other gastrointestinal surgeries that induce chronic malabsorption. * Alcohol or drug abuse within 3 months of informed consent that would interfere with trial participation or any ongoing condition leading to decreased compliance with study procedures or study drug intake. * Chronic or acute pancreatitis. * Pregnancy or breastfeeding (see pregnancy below). * Poorly controlled medical condition, e.g. congestive heart failure (New York Heart Association III-IV or EF ≤ 40%), recent (within 3 months) stroke or acute myocardial infarction or any other condition that in the opinion of the investigator will put the trial participant at risk if participating in the trial. * Allergy to finerenone or any of the excipients contained in the drug. * Current systemic treatment with strong inhibitors of CYP3A4 (e.g. itraconazol, ketoconazole, ritonavir, cobicistat, clarithromycin) or strong inducers of CYP3A4 (e.g. rifampicin, carbamazepine, phenytoin, phenobarbital). * Current treatment with other MRAs (e.g. spironolactone, eplerenone etc.). * Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose- galactose malabsorption. * Addison's disease. * Contraindications to MRI. * Previous renal or heart transplantation.