For patients in the earlier stages of chronic kidney disease (CKD) with type 2 diabetes, preserving the kidneys can help prevent high mortality rates, hospitalizations, and the increased cost to the health system associated with end-stage kidney disease (ESKD). 

For the last two decades, renin-angiotensin system blockade (RAAS) therapy has been the primary medication to help slow kidney disease progression. Unfortunately, this treatment is not always effective. In 2021, dapagliflozin (Farxiga®) and finerenone (Kerendia®) were approved by the FDA to help treat CKD. Learn more about these medications and how they may help to preserve kidney function in patients with type 2 diabetes and CKD.* 

How Are the New Medications Different?

While RAAS treatment attempts to improve blood flow in the kidneys, dapagliflozin and finererone have different goals. Dapagliflozin reduces blood sugars in type 2 diabetes patients and also improves blood pressure and fluid volume, reducing strain on the kidneys. Finererone has anti-inflammatory and anti-fibrotic (anti-scarring) effects that offer the kidneys protection. 

Is There Any Cause for Concern?

Some experts encourage caution around prescribing finerenone to patients with advanced CKD. One main concern is that a 2020 study associated finererone with hyperkalemia (high blood potassium levels), which can be a dangerous side effect if not well-monitored. In a more recent analysis, however, hyperkalemia was found to be uncommon, affecting only about 4.5% of patients taking finererone. Both finerenone and dapagliflozin are strong medications with potentially serious side effects. Speak with your doctor about the benefits and risks of each.

Will These New Medications Make a Difference?

For years, CKD healthcare professionals have longed for better treatment options to halt the progression of CKD in patients with type 2 diabetes. Many are now hopeful that the combination of new and older medications, along with healthy lifestyle choices, will be a more effective approach to slowing the progression of CKD. 

*Singh, A. (2022, April 11). Imagine Halting Progression of Kidney Disease in Patients with Type 2 Diabetes. Nephrology Times. https://www.docwirenews.com/nephtimes/nephtimes-features/nephtimes-columns/nephtimes-from-the-chair/imagine-halting-progression-of-kidney-disease-in-patients-with-type-2-diabetes/