Evidence map›Paper›PMID 40199739›Full record

Observational studyNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2025

Cardio-kidney outcomes for combined versus monotherapy with finerenone or SGLT2 inhibitors in patients with CKD.

Min-Hsiang Chuang, Hsien-Yi Wang, Wei-Chih Kan, Chih-Chiang Chien, Ming-Yan Jiang, Yun-Ting Huang, Vin-Cent Wu, Jui-Yi Chen

Abstract readComparative StudyMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Review
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Min-Hsiang ChuangDivision of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Hsien-Yi WangDivision of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Wei-Chih KanDivision of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Chih-Chiang ChienDivision of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.ORCID 0000-0001-7761-763X
Ming-Yan JiangDivision of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Yun-Ting HuangDivision of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Vin-Cent WuDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.ORCID 0000-0001-7935-0991
Jui-Yi ChenDivision of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.ORCID 0000-0003-1376-7780

Funding

Chi-Mei Medical Center CMFHR113066Chi-Mei Medical Center CMOR11303
6 · The paper itself

Abstract

backgroundSodium-glucose cotransporter 2 inhibitors (SGLT2i) and finerenone each improve kidney and cardiovascular outcomes in patients with chronic kidney disease (CKD). This study compares the association between combined therapy versus monotherapy with SGLT2i or finerenone and the kidney, cardiovascular and mortality outcomes in CKD patients.

methodsThis retrospective cohort study included adults ≥18 years with CKD between 9 July 2021, and 30 November 2023 from multiple centers in the USA, utilizing the TriNetX database. Exposures included treatment with finerenone, SGLT2i or a combination of both. The primary outcome was major adverse kidney events (MAKE). Secondary outcomes included all-cause mortality, major adverse cardiac events (MACE) and end-stage renal disease (ESRD).

resultsA total of 853 patients were included in the combined group [mean (±standard deviation) age, 66.7 ± 11.4 years; 34.9% female], 942 in the finerenone group (mean age, 68.2 ± 11.4 years; 45.8% female) and 45 948 in the SGLT2i group (mean age, 70.2 ± 11.8 years; 41.4% female). After matching, the combined group had less MAKE compared with finerenone monotherapy [adjusted hazard ratio (aHR) 0.20; 95% confidence interval (CI) 0.09-0.45] or SGLT2i monotherapy (aHR 0.44; 95% CI 0.22-0.89). The hazards of all-cause mortality and ESRD were also lower in the combined group compared with either finerenone or SGLT2i alone, while hazard of MACE was similar between the combined and monotherapy groups. The combined group had higher risk of hyperkalemia compared with SGLT2i monotherapy (aHR = 1.36; 95% CI 1.08-1.71).

conclusionCombined therapy with finerenone and SGLT2i is associated with less MAKE and all-cause mortality in CKD patients compared with monotherapy. However, the risk of hyperkalemia with finerenone warrants caution.

Indexed as

Cardiovascular DiseasesNaphthyridinesRenal Insufficiency, ChronicSodium-Glucose Transporter 2 InhibitorsAgedDrug Therapy, CombinationFemaleFollow-Up StudiesGlomerular Filtration RateHumansKidney Failure, ChronicMaleMiddle AgedPrognosisRetrospective StudiesSurvival RatefinerenoneNaphthyridinesSodium-Glucose Transporter 2 Inhibitorschronic kidney diseasefinerenonemajor adverse cardiac eventsmortalitysodium-glucose cotransporter 2 inhibitors

Identifiers

PMID40199739
PMCPMC12477464

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.