Clinical effects of dapagliflozin combined with finerenone in the intervention of early diabetic kidney disease
Wu Yanan
Zou Li
Zhang Bo
Abstract：Objective To explore the clinical effect of dapagliflozin combined with finerenone in the intervention of early di-abetic kidney disease.Methods This study is a retrospective analysis.A total of 68 patients diagnosed with early diabetic kidney disease who received targeted therapy at the Minda Hospital of Hubei Minzu University between March 2023 and September 2023 were enrolled and randomly assigned to a control group and an observation group according to their respective treatment regimens,with 34 patients in each group.The control group received dapagliflozin in addition to standard comprehensive treatment,whereas the observation group received finerenone on the basis of the control group treatment regimen.After 12 weeks of continuous treatment,the systolic blood pressure,diastolic blood pressure,and body mass index of patients in the control group and the observation group were recorded.Blood glucose and lipid metabolism indicatorsof patients,including glycated hemoglobin,fasting blood glucose,2-hour postprandial blood glucose,serumtotal cholesterol,low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),and triglycerides(TG)were measured.Renal function indicatorsin the control group and the observation group,including blood urea nitrogen,serum creatinine(Scr),urine albumin-to-creatinine ratio,and estimated glomerular filtration rate(eGFR)were assessed.Results After treatment,the systolic blood pressure,diastolic blood pressure,body mass index,fasting blood glucose,glycosylated hemoglobin,2-hour postprandial blood glucose,LDL-C and total serum cholesterol in the observation group((135.44±11.20)mmHg(1 mmHg≈0.133 kPa),(80.53±6.03)mmHg,(22.23±1.02)kg·(m2)-1,(7.41±0.77)mmol·L-1,(8.02±0.82)%,(10.62±1.19)mmol·L-1,(3.09±0.53)mmol·L-1,and(5.31±0.54)mmol·L-1,respectively)were lower than those before treatment((145.44±14.80)mmHg,(87.9±10.01)mmHg,(23.82±2.02)kg·(m2)-1,(8.94±1.08)mmol·L-1,(9.35±0.85)%,(13.90±2.85)mmol·L-1,(3.65±0.47)mmol·L-1,(5.87±0.61)mmol·L-1,respectively),with statistically significant differences(t=3.129,3.684,4.081,6.766,3.410,5.590,2.245,3.680,all P<0.05).Aftertreatment,,systolic blood pressure,diastolic blood pressure,body mass index,fasting blood glu-cose,glycosylated hemoglobin,2-hour postprandial blood glucose,serum LDL-C,and total serum cholesterol in the control group were(138.97±14.19)mmHg,(83.18±7.72)mmHg,(22.55±1.21)kg·(m2)-1,(8.12±0.68)mmol·L-1,(8.23±0.96)%,(11.12±1.79)mmol·L-1,(3.03±0.55)mmol·L-1,and(5.43±0.57)mmol·L-1,respectively,lower than those before treatment((148.82±14.63)mmHg,(89.03±9.13)mmHg,(23.38±1.94)kg·(m2)-1,(8.79±1.30)mmol·L-1,(9.58±0.93)%,(13.50±3.15)mmol·L-1,(3.45±0.78)mmol·L-1,and(5.93±0.61)mmol·L-1,respectively),with statistically significant differences(t=2.818,2.854,2.099,2.653,2.420,3.824,2.535,3.504,all P<0.05).Moreover,after treatment,the fasting blood glucose level in the observation group was significantly lower than that in the control group(t=3.728,P<0.05).After treatment,the HDL-C levels in the observation group and the control group were(1.16±0.34)mmol·L-1and(1.15±0.40)mmol·L-1,respectively,higher than those before treatment((1.00±0.35)mmol·L-1 and(1.04±0.32)mmol·L-1,respectively),but the differences were not statistically significant(t=1.123,1.289,both P>0.05).After treatment,the TG levels in the observation group and the control group were(3.92±0.77)mmol·L-1 and(4.14±0.72)mmol·L-1,respectively,lower than those before treatment((4.32±0.79)mmol·L-1 and(4.52±0.92)mmol·L-1,respectively),but the differences were not statistically significant(t=1.929,1.889,both P>0.05).After treatment,the urine albumin-to-creatinine ratio in the observation group and the control group was(443.18±58.15)mg·g-1 and(537.94±98.22)mg·g-1,respectively,lower than those before treatment((583.50±117.72)mg·g-1 and(601.59±129.47)mg·g-1,respectively),with statistically significant differences(t=6.232,2.284,both P<0.05),and the indicator in the observation group was significantly lower than that in the control group(t=4.841,P<0.05).After treatment,the eGFR levels in the observation group and the control group((85.88±8.99)mL·min-1·(1.73 m2)-1 and(84.38±11.05)mL·min-1·(1.73 m2)-1,respectively)were both higher than those before treatment((81.79±8.84)mL·min-1·(1.73 m2)-1 and(82.38±11.69)mL·min-1·(1.73 m2)-1,respectively),but the differences were not statistically significant(t=1.890,0.725,both P>0.05).After treatment,Scr levels in the observation group and the control group((81.68±7.88)μmol·L-1 and(83.26±8.51)μmol·L-1,respectively)were both lower than those before treatment((84.88±9.27)μmol·L-1 and(86.06±9.69)μmol·L-1,respectively),but-the differences were not statistically significant(t=1.535,1.263,both P>0.05).After treatment,BUN levels in the observation group and the control group((6.24±0.98)μmol·L-1 and(6.32±1.08)μmol·L-1,respectively)were lower than those before treatment((6.57±1.07)μmol·L-1 and(6.79±1.19)μmol·L-1,respectively),but the differences were not statistically significant(t=1.299,1.690,both P>0.05).Conclusion Dapagliflozin combined with finerenone can effectively reduce body weight,control blood pressure,blood glucose and blood lipids levels,improve glucolipid metabolism,alleviate the symptoms of early diabetic nephropathy,protect kidney function,and delay or inhibit the progression of the disease.
Keywords：DapagliflozinFinerenoneEarly diabetic kidney diseaseRenin-angiotensin-aldosterone systemUrinary albumin/creatinine ratioClinical efficacy
Publication Date：2025-09-25
Online Publishing Date：2025-10-10(First online date of this platform, not the publication date of the document)
Pages：6( 1047-1052 )