CKD Treatment: Finerenone & Empagliflozin Show Superior Results
New research reveals that combining finerenone and empagliflozin provides superior results for patients battling chronic kidney disease (CKD) and type 2 diabetes. The CONFIDENCE trial found that this combination therapy considerably reduces urinary albumin-to-creatinine ratio (UACR). This is a major step forward for patients. The study,published in The New England Journal of Medicine,supports the early,simultaneous use of both finerenone and empagliflozin,showing a greater reduction of UACR compared to either drug alone. News Directory 3 keeps you informed on the latest medical breakthroughs, including this advance in CKD treatment.Interested in the future of kidney health? Discover what’s next …
Finerenone and Empagliflozin Combination Improves Kidney Health in Type 2 Diabetes Patients
Updated June 13, 2025
Combining finerenone (Kerendia) and empagliflozin (Jardiance) significantly improves kidney health in patients with chronic kidney disease (CKD) and type 2 diabetes, according to research presented at the European Renal Association Congress. The CONFIDENCE clinical trial, published in The New England Journal of medicine, demonstrated that the combination therapy led to a greater reduction in the urinary albumin-to-creatinine ratio (UACR) compared to either treatment alone.
The study addresses a gap in data supporting the combined use of finerenone, a nonsteroidal mineralocorticoid receptor agonist, and sodium-glucose cotransporter-2 inhibitors. Both drugs have individually proven effective in slowing CKD progression and improving cardiovascular outcomes. Researchers designed the CONFIDENCE trial to determine if early, simultaneous use of both medications would more effectively reduce UACR over six months than using either drug separately.
The phase 2 trial involved patients with CKD, albuminuria, and type 2 diabetes already taking a renin–angiotensin system inhibitor. Participants were divided into three groups: one receiving finerenone with a placebo, another receiving empagliflozin with a placebo, and a third receiving both finerenone and empagliflozin. The primary goal was to measure the change in UACR from the start of the trial to day 180, while also monitoring safety.
initial UACR levels were similar across all groups. Though, at day 180, the combination therapy group showed a UACR reduction approximately 29% greater than the finerenone-only group and 32% greater than the empagliflozin-only group. The study also noted that adverse events were uncommon across all treatment arms.
“The CONFIDENCE study delivers the clear message that simultaneous initiation of finerenone and empagliflozin led to an early and additive reduction in UACR of 52% in patients with CKD and type 2 diabetes, which was significantly greater than with either treatment alone,” said Dr. rajiv Agarwal, lead researcher and Professor Emeritus of Medicine at Indiana University’s School of Medicine.
What’s next
These findings suggest a potential shift toward upfront combination therapy in managing CKD and type 2 diabetes, mirroring approaches in othre chronic conditions like heart failure and hypertension. With a critically important percentage of patients achieving the American Diabetes Association’s UACR reduction target, the results could influence clinical decision-making.