ACE and diabetes mellitus: This study aimed to evaluate the efficacy and safety of adding finerenone to angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker (ACEI/ARB) therapy and to identify predictors of clinically meaningful renal deterioration in patients with DN.<h4>Methods</h4>This retrospective cohort study enrolled adult patients (18-80 years) with a confirmed diagnosis of DN according to American Diabetes Association and Kidney Disease: Improving Global Outcomes criteria, who had complete baseline and follow-up data.