In this retrospective, single-center study of patients with HFrEF or HFmrEF complicated by DM and CKD, initiation of finerenone was associated with significant improvements in NT pro-BNP levels and indices of left ventricular remodeling, including reduced left ventricular end-diastolic diameter and increased LVEF, without deterioration in renal function or development of hyperkalemia. Here, NPPB is linked to chronic kidney disease.