Objective To investigate the clinical effect of finerenone combined with metformin for the treatment of diabetic nephropathy (DN). Methods A total of 86 patients with DN were randomly divided into control group (n=43) or observation group (n=43). On the basis of conventional treatment, the control group received metformin for treatment, while the observation group received finerenone combined with metformin for treatment. Blood glucose indicators in terms of fasting blood glucose (FBG), HbA1c, 2⁃hour postprandial blood glucose (2hPBG), fasting insulin (FINS), renal function indicators with respect to urinary microalbumin (UmALB), urinary albumin⁃to⁃creatinine ratio (UACR), serum creatinine (Scr), serum renal fibrosis indicators including hyaluronic acid (HA), laminin (LN), type Ⅳ collagen (Ⅳ⁃C), procollagen type Ⅲ (PCⅢ), and inflammatory indicators (monocyte chemoattractant protein 1 ［MCP⁃1］, C⁃C motif chemokine ligand 2 ［CCL2］, intercellular adhesion molecule 1 ［ICAM⁃1］), as well as clinical efficacy were compared between the two groups before and after treatment. Results After 3 months of treatment, the levels of FBG, HbA1c, 2hPBG, and FINS in both groups decreased compared with before treatment (P<0.05), but there was no statistically significant difference between the two groups (P>0.05). The levels of UmALB, Scr, HA, LN, Ⅳ⁃C, PCⅢ, MCP⁃1, CCL2, ICAM⁃1, and UACR value in both groups decreased compared with before treatment, and the observation group yielded lower levels and value as compared with the control group (P<0.05). The total effective rate of treatment in the observation group was higher than that in the control group (P<0.05). Conclusion Finerenone combined with metformin can effectively improve renal function and renal fibrosis, reduce inflammatory responses, and enhance clinical efficacy in patients with DN, which is of positive significance for the treatment of DN.  

【Key words】 Diabetic nephropathy, Finerenone, Metformin, Blood glucose, Renal function, Renal fibrosis, Inflammatory indicators

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