A Study Comparing the Clinical Benefit of Finerenone Versus a Fixed Dose Combination (FDC) of Extended-Release Torsemide and Spironolactone in Patients With Hypertension and Chronic Kidney Disease

This study is comparing two treatments for adults with chronic kidney disease (CKD) and high blood pressure: finerenone (an existing kidney-protecting drug) versus a fixed-dose combination pill containing extended-release torsemide and spironolactone. The goal is to see which approach better reduces protein in the urine and protects kidney function. **You may be eligible if...** - You are 18 years or older - You have been diagnosed with chronic kidney disease with moderately reduced kidney function (eGFR between 25 and 60) - You have a significant amount of protein in your urine and mildly elevated potassium - Your blood pressure is elevated (systolic between 130 and 170 mmHg) - You are currently on a low dose of finerenone (10 mg/day) and a loop diuretic (such as furosemide) **You may NOT be eligible if...** - You have Type 1 diabetes - Your blood pressure is very high (above 170 mmHg systolic) - You have very high or very low potassium levels outside the specified range - You have had a recent heart attack, stroke, or acute kidney injury in the past 3 months - You have adrenal insufficiency or primary aldosteronism Talk to your doctor to see if this trial is right for you.