Efficacy of finerenone combined with sacubitril/valsartan and dapagliflozin in the treatment of early diabetic kidney disease
ZHANG Qiuyang
LIU Jinrui
WU Xiang
ZHANG Jinghua
Abstract：Objective To explore the clinical effects of oral treatment with finerenone combined with sacubitril/val-sartan and dapagliflozin on early diabetic kidney disease.Methods Sixty-eight patients with early type 2 diabetic ne-phropathy were selected as the study subjects.Under the principle of balanced and comparable baseline data such as age and gender,the subjects were divided into the control group of 33 cases and experimental group of 35 cases.The control group was treated with sacubitril/valsartan and dapagliflozin,while the experimental group was treated with finerenone in addition to the treatment of the control group for a total of 12 months.We compared the renal function indicators[serum creatinine(Cr),blood urea nitrogen(BUN),estimated glomerular filtration rate(eGFR),uric acid(UA),urinary micro-albumin(MALB),and urinary microalbumin-to-creatinine ratio(ACR)],blood glucose indicators[fasting blood glucose(FPG)and glycosylated hemoglobin A1c(HbA1c)],blood pressure indicators[systolic blood pressure(SBP)and diastol-ic blood pressure DBP],blood potassium and inflammation related indicators[white blood cells(WBC),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)]before and after treatment between two groups,and recorded and compared the occurrence of adverse reactions(headache,dizziness,nausea,vomiting,hyperkalemia,and hypotension)between the two groups.Results After treatment,BUN,MALB,ACR,HbA1c,FPG,SBP,DBP,WBC,IL-6,and TNF-α in both groups decreased in comparison with those before treatment(all P<0.05).The Cr level in the experimental group was lower than that in the control group after 12 months of treatment,while eGFR and blood potassium levels were higher than those in the control group after 12 months of treatment.BUN,MALB,and ACR levels were lower than those in the control group after 6 and 12 months of treatment.WBC,IL-6,TNF-α,and SBP levels were lower than those in the con-trol group after 3,6,and 12 months of treatment(all P<0.05).There were no statistically significant differences in the in-cidence of headache,dizziness,nausea and vomiting,hyperkalemia,or hypotension between the two groups(all P>0.05).Conclusions Oral treatment of early diabetic kidney disease with finerenone combined with sacubitril/valsartan and dapagliflozin can effectively reduce urinary protein,improve renal function,control blood sugar and inflammatory reac-tion,and help long-term blood pressure management.However,there is a risk of increasing blood potassium during the use of finerenone,and blood potassium levels need to be regularly measured.
Keywords：early diabetic nephropathyfinerenonesacubitril/valsartandapagliflozin
Publication Date：2025-12-25
Online Publishing Date：2026-01-12(First online date of this platform, not the publication date of the document)
Pages：6( 1-6 )