The effectiveness of dapagliflozin and finerenone in reducing albuminuria and slowing the progression of chronic kidney disease (CKD) has been established, but their additive effects have yet to be studied.
According to a study published in the Clinical Kidney Journal, Combining finerenone and dapagliflozin reduced albuminuria safely. Their combined effect was at least equal to each drug's effect alone, suggesting an additive effect.

The present study aimed to compare these two medications' individual and combined efficacy and safety in patients with non-diabetic CKD.
In a randomized, open-label clinical trial, researchers enrolled patients aged 18-80. These patients were on the maximum tolerated dose of an ACE inhibitor or angiotensin receptor blocker and had an eGFR of 25-45 mL/min/1,73 m[2] and albuminuria ranging from 150-2000 mg/g. The participants were assigned to receive either finerenone 20 mg/day or dapagliflozin 10 mg/day for a duration of four weeks, followed by a combination therapy for four weeks. Data were collected at the beginning of the study and weeks 4 and 8.
Key results from the study are:
· Twenty patients (10 in each group) were included in this study.
· These patients had a mean mgfr of 34 ml/min/1,73 m[2] and a mean urine albumin creatinine ratio (UACR) of 469 mg/g.
· Patients receiving finerenone alone or in combination with dapagliflozin experienced a -24% and -34% change in UACR, respectively
· Patients taking dapagliflozin alone or combined with finerenone experienced a -8% and -10% uacr change, respectively.
· Uacr change was -36% after eight weeks. Additionally, systolic blood pressure and mGFR decreased by 10 mmHg and 7 ml/min/1,73 m[2].
· Adverse effects were minimal
The administration of finerenone and dapagliflozin was found to be safe and resulted in a marked reduction in albuminuria in this study. The efficacy of combination therapy was comparable to the combined effects of each drug, suggesting an additive impact on albuminuria. More extensive research is necessary to evaluate this approach's long-term benefits and safety.
Reference:
Mårup, Frederik Husum, et al. "Additive Effects of Dapagliflozin and Finerenone On Albuminuria in Non-diabetic CKD: an Open-label Randomized Clinical Trial." Clinical Kidney Journal, vol. 17, no. 1, 2024, pp. sfad249.