Real-World Effectiveness of Finerenone Added to SGLT2 Inhibitor and GLP-1 Receptor Agonist Therapy in Individuals with Type 2 Diabetes and Chronic Kidney Disease.

Nakhleh A, Khazim K, Shehadeh N

Journal of clinical medicine19 Nov 2025Cited by 2 (Europe PMC)

PMID41303244PMCIDPMC12653522DOI10.3390/jcm14228209PepBankPUB-41303244

Summary

Background/Objectives: Recent randomized controlled trial evidence in adults with type 2 diabetes (T2D) and chronic kidney disease (CKD) indicates that adding finerenone to empagliflozin provides additive clinical benefit. A prespecified analysis demonstrates that this benefit is consistent irrespective of prior glucagon-like peptide-1 receptor agonist (GLP-1 RA) use. We aimed to assess the effectiveness of adding finerenone to existing sodium-glucose cotransporter-2 inhibitor (SGLT2i) and GLP-1 RA therapy in a real-world setting. Methods: We performed a retrospective cohort study of adults with T2D and CKD from Maccabi Healthcare Services diabetes, endocrinology, and nephrology clinics in Haifa, Israel. Included individuals initiated finerenone between 1 August 2023, and 31 January 2025, and met the following criteria: estimated glomerular filtration rate (eGFR) of 25-60 mL/min/1.73 m²; urinary albumin-to-creatinine ratio (UACR) > 300 mg/g; and a history of ≥12 weeks of SGLT2i (empagliflozin or dapagliflozin) and GLP-1 RA (liraglutide, dulaglutide, or semaglutide) use prior to finerenone initiation. Outcomes were assessed at the last measurement taken within 26 ± 10 weeks of finerenone initiation. The primary outcome was adjusted percent change in log-transformed UACR from baseline to follow-up. Secondary outcomes were adjusted mean changes in eGFR and serum potassium. We used multiple linear regression models. Prespecified subgroup analyses examined the UACR change by age, sex, body mass index (BMI), baseline eGFR, and baseline UACR. Results: Fifty-one individuals were included in the study, with a mean age of 66.0 ± 9.5 years and a mean BMI 30.9 ± 5.2 kg/m². The median eGFR was 45 mL/min/1.73 m² (IQR 36-52), and the median UACR was 1001 mg/g (IQR 515-1599). 94% were receiving a renin-angiotensin system inhibitor. Finerenone was initiated at 10 mg/day and titrated to 20 mg/day in eight individuals. Over a median follow-up of 27 weeks, the adjusted percent change in UACR was -51.3% (p < 0.001), consistent across prespecified subgroups. The adjusted mean eGFR change was -3.92 mL/min/1.73 m² (p < 0.001). Serum potassium increased by +0.34 mmol/L (p < 0.001). Conclusions: In adults with T2D and albuminuric CKD already receiving an SGLT2i and a GLP-1 RA, adding finerenone substantially reduced albuminuria.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study7

No result from this study comes from a test of the peptide.

Studies that did not test the peptide alone7

In this study, the peptide was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking the peptide.

01HumanNot a test of Dulaglutide (Trulicity) aloneObservational studyEfficacy outcome
In adults with T2D and CKD, adding finerenone to pooled SGLT2i and GLP-1RA therapy was linked to reduced UACR.
In plain wordsAdding finerenone to pooled SGLT2i and GLP-1RA therapy was linked to lower urine albumin versus baseline in adults with T2D and CKD.
Peptide
Dulaglutide (Trulicity)
Outcome
DecreaseUACR change
Study
n = 51
Comparator
Baseline
Analysis
Primary
Outcome group
Kidney function · Kidney and urinary
Measurements
Adjusted UACR change
−51.3%
Follow-up versus baseline
Source sentences
Summary
Over a median follow-up of 27 weeks, the adjusted percent change in UACR was -51.3% (p < 0.001), consistent across prespecified subgroups.
2 context sentences(design, population, supporting numbers)
Summary · context
We performed a retrospective cohort study of adults with T2D and CKD from Maccabi Healthcare Services diabetes, endocrinology, and nephrology clinics in Haifa, Israel.
Summary · context
We aimed to assess the effectiveness of adding finerenone to existing sodium-glucose cotransporter-2 inhibitor (SGLT2i) and GLP-1 RA therapy in a real-world setting.
In this study, Dulaglutide (Trulicity) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Dulaglutide (Trulicity).
Show in the study text Report a problemFND-4130324401
02HumanNot a test of Liraglutide aloneObservational studyEfficacy outcome
In adults with T2D and CKD, adding finerenone to pooled SGLT2i and GLP-1RA therapy was linked to reduced UACR.
In plain wordsAdding finerenone to pooled SGLT2i and GLP-1RA therapy was linked to lower urine albumin versus baseline in adults with T2D and CKD.
Peptide
Liraglutide
Outcome
DecreaseUACR change
Study
n = 51
Comparator
Baseline
Analysis
Primary
Outcome group
Kidney function · Kidney and urinary
Measurements
Adjusted UACR change
−51.3%
Follow-up versus baseline
Source sentences
Summary
Over a median follow-up of 27 weeks, the adjusted percent change in UACR was -51.3% (p < 0.001), consistent across prespecified subgroups.
2 context sentences(design, population, supporting numbers)
Summary · context
We performed a retrospective cohort study of adults with T2D and CKD from Maccabi Healthcare Services diabetes, endocrinology, and nephrology clinics in Haifa, Israel.
Summary · context
We aimed to assess the effectiveness of adding finerenone to existing sodium-glucose cotransporter-2 inhibitor (SGLT2i) and GLP-1 RA therapy in a real-world setting.
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-4130324402
03HumanNot a test of Semaglutide aloneObservational studyEfficacy outcome
In adults with T2D and CKD, adding finerenone to pooled SGLT2i and GLP-1RA therapy was linked to reduced UACR.
In plain wordsAdding finerenone to pooled SGLT2i and GLP-1RA therapy was linked to lower urine albumin versus baseline in adults with T2D and CKD.
Peptide
Semaglutide
Outcome
DecreaseUACR change
Study
n = 51
Comparator
Baseline
Analysis
Primary
Outcome group
Kidney function · Kidney and urinary
Measurements
Adjusted UACR change
−51.3%
Follow-up versus baseline
Source sentences
Summary
Over a median follow-up of 27 weeks, the adjusted percent change in UACR was -51.3% (p < 0.001), consistent across prespecified subgroups.
2 context sentences(design, population, supporting numbers)
Summary · context
We performed a retrospective cohort study of adults with T2D and CKD from Maccabi Healthcare Services diabetes, endocrinology, and nephrology clinics in Haifa, Israel.
Summary · context
We aimed to assess the effectiveness of adding finerenone to existing sodium-glucose cotransporter-2 inhibitor (SGLT2i) and GLP-1 RA therapy in a real-world setting.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-4130324403
04HumanNot a test of Dulaglutide (Trulicity) aloneObservational studyEfficacy outcome
In adults with T2D and CKD, adding finerenone to pooled SGLT2i and GLP-1RA therapy was linked to reduced eGFR.
In plain wordsAdding finerenone to pooled SGLT2i and GLP-1RA therapy was linked to lower eGFR versus baseline in adults with T2D and CKD.
Peptide
Dulaglutide (Trulicity)
Outcome
DecreaseeGFR change
Study
n = 51
Comparator
Baseline
Analysis
Secondary
Outcome group
Kidney function · Kidney and urinary
Measurements
Adjusted mean eGFR change
−3.92 mL/min/1.73 m2
Follow-up versus baseline
Source sentences
Summary
The adjusted mean eGFR change was -3.92 mL/min/1.73 m² (p < 0.001).
2 context sentences(design, population, supporting numbers)
Summary · context
We performed a retrospective cohort study of adults with T2D and CKD from Maccabi Healthcare Services diabetes, endocrinology, and nephrology clinics in Haifa, Israel.
Summary · context
We aimed to assess the effectiveness of adding finerenone to existing sodium-glucose cotransporter-2 inhibitor (SGLT2i) and GLP-1 RA therapy in a real-world setting.
In this study, Dulaglutide (Trulicity) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Dulaglutide (Trulicity).
Show in the study text Report a problemFND-4130324404
05HumanNot a test of Liraglutide aloneObservational studyEfficacy outcome
In adults with T2D and CKD, adding finerenone to pooled SGLT2i and GLP-1RA therapy was linked to reduced eGFR.
In plain wordsAdding finerenone to pooled SGLT2i and GLP-1RA therapy was linked to lower eGFR versus baseline in adults with T2D and CKD.
Peptide
Liraglutide
Outcome
DecreaseeGFR change
Study
n = 51
Comparator
Baseline
Analysis
Secondary
Outcome group
Kidney function · Kidney and urinary
Measurements
Adjusted mean eGFR change
−3.92 mL/min/1.73 m2
Follow-up versus baseline
Source sentences
Summary
The adjusted mean eGFR change was -3.92 mL/min/1.73 m² (p < 0.001).
2 context sentences(design, population, supporting numbers)
Summary · context
We performed a retrospective cohort study of adults with T2D and CKD from Maccabi Healthcare Services diabetes, endocrinology, and nephrology clinics in Haifa, Israel.
Summary · context
We aimed to assess the effectiveness of adding finerenone to existing sodium-glucose cotransporter-2 inhibitor (SGLT2i) and GLP-1 RA therapy in a real-world setting.
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-4130324405
06HumanNot a test of Semaglutide aloneObservational studyEfficacy outcome
In adults with T2D and CKD, adding finerenone to pooled SGLT2i and GLP-1RA therapy was linked to reduced eGFR.
In plain wordsAdding finerenone to pooled SGLT2i and GLP-1RA therapy was linked to lower eGFR versus baseline in adults with T2D and CKD.
Peptide
Semaglutide
Outcome
DecreaseeGFR change
Study
n = 51
Comparator
Baseline
Analysis
Secondary
Outcome group
Kidney function · Kidney and urinary
Measurements
Adjusted mean eGFR change
−3.92 mL/min/1.73 m2
Follow-up versus baseline
Source sentences
Summary
The adjusted mean eGFR change was -3.92 mL/min/1.73 m² (p < 0.001).
2 context sentences(design, population, supporting numbers)
Summary · context
We performed a retrospective cohort study of adults with T2D and CKD from Maccabi Healthcare Services diabetes, endocrinology, and nephrology clinics in Haifa, Israel.
Summary · context
We aimed to assess the effectiveness of adding finerenone to existing sodium-glucose cotransporter-2 inhibitor (SGLT2i) and GLP-1 RA therapy in a real-world setting.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-4130324406
07HumanNot a test of Dulaglutide (Trulicity) aloneObservational studySafety outcome
In adults with T2D and CKD, adding finerenone to pooled SGLT2i and GLP-1RA therapy was linked to increased serum potassium.
In plain wordsAdding finerenone to pooled SGLT2i and GLP-1RA therapy was linked to higher potassium versus baseline in adults with T2D and CKD.
Peptide
Dulaglutide (Trulicity)
Outcome
IncreaseSerum potassium
Study
n = 51
Comparator
Baseline
Analysis
Secondary
Outcome group
Adverse events · Kidney and urinary
Measurements
Serum potassium change
0.34 mmol/L
Follow-up versus baseline
Source sentences
Summary
Serum potassium increased by +0.34 mmol/L (p < 0.001).
2 context sentences(design, population, supporting numbers)
Summary · context
We performed a retrospective cohort study of adults with T2D and CKD from Maccabi Healthcare Services diabetes, endocrinology, and nephrology clinics in Haifa, Israel.
Summary · context
We aimed to assess the effectiveness of adding finerenone to existing sodium-glucose cotransporter-2 inhibitor (SGLT2i) and GLP-1 RA therapy in a real-world setting.
In this study, Dulaglutide (Trulicity) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Dulaglutide (Trulicity).
Show in the study text Report a problemFND-4130324407

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 4Current
22 Oct 2026, 02:25 UTC
Study results updated
Versions 2 to 3
21 Oct 2026, 18:59 UTC
The same notice was added 2 times, first on 9 Oct 2026, 03:06 UTC. The status did not change between them.
Study data updated · source update from Europe PMC
Version 1
9 Oct 2026, 03:05 UTC
First added · source update from Europe PMC

Real-World Effectiveness of Finerenone Added to SGLT2 Inhibitor and GLP-1 Receptor Agonist Therapy in Individuals with Type 2 Diabetes and Chronic Kidney Disease.

Summary

Results from this study7

Studies that did not test the peptide alone7

Version history

Subjects

Publication types

Keywords