The ongoing ‘Proteomic prediction and Renin angiotensin aldosterone system Inhibition prevention Of early diabetic nephRopathy in TYpe 2 diabetic patients with normoalbuminuria’ (PRIORITY) trial is investigating the efficacy of the mineralocorticoid receptor antagonist (MRA) spironolactone, in terms of delaying the progression of early diabetic nephropathy (DN) [2]. However, concerns regarding the development of hyperkalemia in those with decreased renal function need to be addressed. The nonsteroidal MRA finerenone (BAY 94-8862) was well-tolerated in a Japanese population with DN and did not exert adverse effects on serum potassium levels or renal function [3,4]. A study of the safety of the selective aldosterone receptor antagonist MT-3995 regarding the development of hyperkalemia in subjects with DN is required [5].

We appreciate your interest in, and comments on, our article and we hope that our revisions have addressed your concerns.