Background: Over the last decades, the use of renin–angiotensin system (RAS) blockers has been the mainstay for retarding progression of DKD, along with lifestyle modifications and blood pressure (BP) and glycemic control. Despite the indisputable nephroprotective effects of RAS blockers, accumulated evidence suggests persistence of a high residual risk for CKD and cardiovascular (CVD) progression in these patients, underlining the need for further research to establish novel treatment approaches. Double RAS blockade, initially associated with greater reductions in albuminuria compared to single blockade, was terminally abandoned in the form of a combination of an angiotensin converting enzyme inhibitor (ACEi) with an angiotensin receptor blocker [ARB], or of a renin inhibitor with an ACEi/ARB in diabetics and all other populations, in view of safety concerns raised after publication of two major cardiovascular and renal outcome trials. Steroidal mineralocorticoid receptor antagonists (MRAs) have proven to be effective in the management of primary aldosteronism due to bilateral adrenal hyperplasia or aldosterone-producing adrenal adenomas, in the treatment of resistant hypertension, as well as in the reduction of albuminuria in patients with diabetic and non-diabetic nephropathy (alone or on top of an RAS blocker). Large-scale clinical trials have recently provided evidence of improved renal and cardiovascular outcomes with addition of finerenone to the standard of care in patients with type 2 DM and moderately or severely increased albuminuria