• Posted June 9, 2025

Combo Drug Treatment More Effective For Kidney Disease in Type 2 Diabetics

MONDAY, June 9, 2025 (HealthDay News) — Prompt treatment with a drug combo can effectively manage chronic kidney disease in people with type 2 diabetes, a new clinical trial shows.

Patients prescribed the combination of finerenone and empagliflozin experienced a 52% decrease in their urinary albumin-to-creatinine ratio, researchers report in the New England Journal of Medicine. An elevated ratio is a sign of kidney damage.

These results were “significantly greater than with either treatment alone,” lead researcher Dr. Rajiv Agarwal, a professor emeritus at the Indiana University School of Medicine, said in a news release.

“In other chronic conditions like heart failure or hypertension, we’re moving away from the traditional stepwise approach toward upfront combination therapy,” Agarwal said, noting the same tactics could be useful in treatment of kidney disease.

Finerenone (Kerendia) is thought to work by inhibiting inflammation that can cause kidney damage, according to Drugs.com.

The second drug in the combo — empagliflozin (Jardiance) — belongs to a class of diabetes medications called SGLT2 inhibitors, which lower blood sugar by causing more glucose to be excreted in urine.

People who have both kidney disease and type 2 diabetes face increased risks of heart disease and kidney failure, researchers said in background notes.

To see if giving these patients both drugs would help, researchers recruited 818 people and randomly assigned them to take daily doses of either each drug alone or both together.

After six months, the combo group had a 52% reduction in their albumin-to-creatinine ratio (UACR), compared with 29% with finerenone alone and 32% with empagliflozin alone. 

Albumin is an important blood-borne protein not normally found in urine. Damaged kidneys will leak albumin into urine; thus, the protein is a sign of kidney disease, according to the National Kidney Foundation.

In the new clinical trial, “70% of patients on both therapies achieved the American Diabetes Association-recommended UACR reduction target of greater than 30%,” Agarwal said. “Since UACR is a key mediator of kidney and cardiovascular outcomes, these results are highly relevant for clinical decision-making.”

Researchers also presented their findings Thursday at the European Renal Association’s annual meeting in Vienna.

More information

The National Kidney Foundation has more about albuminuria.

SOURCE: European Renal Association, news release, June 5, 2025