A 24-month real-world cohort study of 121 patients with non-diabetic chronic kidney disease found that starting finerenone was associated with reduced albuminuria and proteinuria and a significant slowing of kidney function decline. The study reported hyperkalemia in fewer than 5% of participants and no serious adverse events. The results add to the evidence base supporting mineralocorticoid pathway inhibition beyond diabetic populations, where therapeutic decision-making often hinges on balancing renal benefit against hyperkalemia risk. Real-world datasets can reflect heterogeneous comorbidity burdens and dosing practices compared with tightly controlled trials. Clinicians will likely look for subgroup durability signals, monitoring practices, and how the risk-benefit profile compares with alternative renoprotective regimens in routine care.