Abstract: SA-PO0817
Efficacy of Combining Dapagliflozin and Finerenone in IgAN
Session Information
- Glomerular Management: Real-World Lessons and Emerging Therapies
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Fang, Ming, Department of Nephrology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Li, Xinwei, Department of Nephrology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Zhou, Jingying, Department of Nephrology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Kang, Le, Medical College of Dalian University, Dalian, China
Background
Current optimal supportive care for IgA nephropathy (IgAN) focuses on RASi and SGLT2i to mitigate proteinuria and preserve renal function. This study aims to evaluate the efficacy and safety of finerenone, with or without dapagliflozin, in patients with biopsy-proven IgAN.
Methods
Twenty-two biopsy-confirmed IgAN patients completing 9-month finerenone therapy were enrolled. 24-hour urinary protein, estimated glomerular filtration rate (eGFR), serum potassium, and adverse events were collected.
Results
At baseline: median proteinuria 1079.50 mg/day (IQR: 872.50–2338.50), mean eGFR 65.74±19.66 mL/min/1.73m2, serum potassium 4.24±0.37 mmol/L. After 9 months treatment, finerenone reduced median proteinuria by 46%, with complete remission (proteinuria <500 mg/day) in 31.8% (7/22) and partial remission (≥50% reduction and <1000 mg/day) in 13.6% (3/22). Proteinuria reduction was independent of dapagliflozin (P=0.188) but enhanced in combination. Mean eGFR declined 5.88 mL/min/1.73m2 (95% CI: 1.64–10.11); serum potassium remained stable (4.47 mmol/L [95% CI: 4.32–4.62]; P=0.100 vs baseline). One transient hyperkalemia (6.29 mmol/L) resolved spontaneously. No serious adverse events occurred.
Conclusion
Finerenone exhibits clinically significant antiproteinuric effects in IgAN, potentially enhanced by dapagliflozin combination, with preserved potassium homeostasis and manageable eGFR decline. These findings may support the use of finerenone in IgAN.