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‹ Mon · 1 Jun 2026
Near-term implementable finding

Adding Finerenone to SGLT2 Inhibitors and Long-Term Kidney Outcomes in Diabetic Kidney Disease

Adding a fourth blood pressure drug to standard kidney-disease therapy significantly slows kidney decline in diabetic patients.

In 255 DKD patients on RASi+SGLT2i, adding finerenone (triple combination) versus continuing dual therapy was associated with significantly greater proteinuria reduction (47% at 24 months) and a meaningful improvement in long-term eGFR slope after PS matching. The findings support triple combination therapy as an additional renoprotective strategy in DKD, complementing existing evidence from the FIDELIO-DKD and FIGARO-DKD trials.

What the study was

Study design
Retrospective cohort with propensity score matching (intention-to-treat)
Population
DKD patients on combined RASi + SGLT2i therapy at two centers in Japan; triple therapy (n~127) vs dual therapy (n~128 after PS matching)
Sample size
255
Category
Treatment Innovation
Maturity
Validated
Journal
Diabetes Obes Metab

Why it surfaced

Real-world evidence supporting triple combination (finerenone+RASi+SGLT2i) as a renoprotective strategy in DKD; fills a gap not directly addressed by pivotal RCTs; clinically applicable now pending guideline uptake.

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