Kidney Effects of Finerenone Added to Sodium‐Glucose Cotransporter 2 Inhibitors in Patients With Diabetic Kidney Disease
Main finding · ≥ 30% eGFR declineResult — go to the resultHazard ratio 0.26 95% CI 0.11–0.57Authors' conclusion
Finerenone added to SGLT-2Is was associated with slower eGFR decline in most individuals with T2D-CKD. However, people with rapid pre-treatment eGFR decline may experience accelerated deterioration when finerenone is added.
Study context
- Population
- People with T2D and chronic kidney disease (CKD), West China Hospital of Sichuan University; baseline mean age 54.5 years, eGFR 68.8 mL/min/1.73 m², eGFR slope −2.1 mL/min/1.73 m²/yearmatched cohort
- Participants
- 69 vs 228
- Exposure
- Finerenone added to SGLT-2Is vs SGLT-2Is alone
- Finerenone + SGLT-2Isn = 69
- SGLT-2Isn = 228reference
- Outcome
- Time from drug initiation to ≥ 30% decline in eGFR
- Follow-up
- Median 18.1 months
Methodological detailssingle-centre, 1:4 propensity-score matched
- Single-centre
- 1:4 propensity-score matched
Main finding
≥ 30% eGFR decline
Hazard ratio
0.26
95% CI 0.11–0.57
Finerenone + SGLT-2Isvs SGLT-2Is
HR 0.26 (95% CI 0.11–0.57)
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Mean difference (mL/min/1.73 m²/year) (95% CI) | |
|---|---|---|
| Chronic eGFR slope, subgroup with rapid pre-treatment eGFR decline | −6.28 (−11.81 to −0.75) | |
| −15−10−505Difference, mL/min/1.73 m²/year (linear scale) |
- Chronic eGFR slope, subgroup with rapid pre-treatment eGFR decline: significantly greater eGFR decline with finerenone on SGLT-2Is
Change in chronic eGFR slope (secondary outcome) · median follow-up 18.1 months
- Between-group difference in post-treatment chronic eGFR slope
- −0.74 mL/min/1.73 m²/year (95% CI: −2.95-1.45)
Original publication
Kidney Effects of Finerenone Added to Sodium‐Glucose Cotransporter 2 Inhibitors in Patients With Diabetic Kidney Disease. Diabetes Obes Metab. Published 3 May 2026. doi:10.
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