Introduction and Objective: Evaluate the additional role of Finerenone (Fi) on renal markers (RM) in T2DM patients with diabetic nephropathy (DN) Stages 1-3, receiving angiotensin receptors blocker (ARB) [Valsartan {V} or Telmisartan {Tm}], SGLT2i (dapagliflozin) {D} & optimized for Blood Pressure (BP) <130/80mm for at least 1 yr.Methods: Between Oct’ 22 & Mar’ 23, 60 T2DM pt’s with DN irrespective of A1c, on regular F/U receiving D, ARB, Fi & optimized for BP (using CCB &/or Beta-blocker) were retrospectively analyzed. Pt’s were followed for 6 months. Weight-kg (W), BMI-kg/m2, SBP/DBP (mm Hg), lipid profile mg/dL (TC, LDL, TG, HDL), hs-CRP mg/L, NT-ProBNP pg/ml, eGFR (Cr & Cyst-C), K+ mEq/L & UACR μg/mg were analyzed every 2-3 moths. Exclusion: H/O any revascularization, IHD, hospitalization in last 1 year, eGFR < 30 & K+ > 5.5 mEq/L. Statistical analysis: Paired ‘t’ test assessed within-group comparisons. P-value < 0.05 was considered significant (S).Results: Baseline (B): 80% (eGFR > 60.0). 86.66% patients (UACR 30 – 300). Mean age-yrs (60.05 ± 10.21), W (74.25 ± 15.14), SBP (124.4 ± 13.7), DBP (78.32 ± 10.51), A1c (7.16 ±0.169), eGFRCr (88.96 ± 33.15), eGFRCy (65.2 ± 22.115), K+ (4.576 ± 0.45), UACR (170.76 ± 241.84), hsCRP (1.35 ± 1.13), NTProBNP (106.87 ± 100.68). Avg doses: V (112 ± 39.2), Tm (87.43 ± 43.37), Fi (12.67 ± 4.43). ARBs (66.66%), ARNI (33.33%), CCBs (33.33%), Beta-blockers (30%). B-6 mths: S reduction in UACR (101.348 ± 33.93, p<0.001) S increase in W (-0.8 ± 0.294, p = 0.025) were seen. Non-S reductions in SBP (1.33 ± 1.671, p = 1), DBP (1.9 ± 1.34, p = 0.486), A1c (0.038 ± 0.105, p = 1.000), eGFRCr (-0.713 ± 2.22, p = 1), eGFRCy (-6.0 ±3.26, p=0.063) K+ (-0.007 ± 0.048, p = 0.1), NTProBNP (11.018 ± 5.69, p = 0.174). Avg doses: V (96 ± 32), Tm (111.43 ± 55.42), Fi (16.70 ± 4.92).Conclusion: In T2DM pt’s with stage 1-3 nephropathy receiving SGLT2i (D), ARB & optimized for BP, the addition of Fi over 6 months led to significant 59.35% reduction in UACR.
V. Gupta: None.
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