Efficacy of Finerenone Combined with SGLT2 Inhibitors in the Treatment of Diabetic Kidney Disease

Background: This study investigates the safety and efficacy of finerenone in combination with sodium-glucose co-transporter protein 2 inhibitor(SGLT2i) compared with monotherapy in the treatment of diabetic kidney disease(DKD), to provide clinical data for the selection of treatment options for diabetic nephropathy. Methods: A total of 100 patients with type 2 diabetes mellitus(T2DM) combined with diabetic nephropathy and/or urinary microalbumin/creatinine ratio >30mg who were hospitalized in the hospital or at tended outpatient clinics from January 1, 2022 to January 1, 2025 were collect ed, and were separated into two groups based on their treatment methods: the SGLT2i treatment groupand the finerenone combined with SGLT2i treatment group . All the patients were treated with conventional dietary control and glucose-lowering therapy. General clinical data of the included patients were collected, Data were processed using SPSS 27.0 software, P < 0.05 means that the difference was statistically significant. Results: After 3 months of treatment in the finerenone combined with SGLT2i group, patients' mALB , UACR, HbA1c, and TC were significantly decreased compared with before, and the difference was statistically significant (P<0.05), blood K+ was significantly increased compared with pre-treatment, and the difference was statistically significant (P<0.05), CR, and BUN were not significantly increased compared with pre-treatment, and eGFR did not significantly decrease compared with pre-treatment, and the difference was not statistically significant (P > 0.05). Compared with the SGLT2i group, the decrease in UACR after 3 months of treatment was significantly greater in the finerenone combined with SGLT2i group, and the difference was statistically significant (P< 0.05); the increases in CR and blood K+ were all greater, but the difference was not statistically significant (P > 0.05). Conclusion: The combination of finerenone with SGLT2i provides better renoprotection compared to SGLT2i alone, but finerenone has a risk of hyperkalemia in its application and requires regular monitoring and follow-up. Funding: Government Support – Non-U.S.