{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T06:31:25Z","timestamp":1793341885332,"version":"4.5.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004326","name":"Bayer AG","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004326","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,30]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Concurrent initiation of finerenone and empagliflozin can lower albuminuria more than component therapies at Day 180 in participants with chronic kidney disease (CKD) and type 2 diabetes (T2D\u00a0). We evaluated baseline clinical characteristics and longitudinal changes in urinary albumin-to-creatinine ratio (UACR) across age and sex cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In CONFIDENCE (NCT05254002), participants with T2D, CKD (estimated glomerular filtration rate [eGFR] 30\u201390 ml\/min\/1.73 m2), and albuminuria (UACR 100 to &amp;lt;5000 mg\/g) on stable doses of renin\u2013angiotensin system inhibitors were randomized 1:1:1 to empagliflozin 10 mg\/day, finerenone 10 or 20 mg\/day, or both. We stratified participants by age quartiles (\u226460 years, 61\u201368 years, 69\u201374 years , &amp;gt;74 years) and sex. Outcomes included % change in UACR from baseline over time and incidences of key adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Increasing age was associated with higher baseline prevalence of atherosclerotic cardiovascular disease and lower eGFR. Older age was a significant predictor of UACR reduction, with \u201310.2% (95% CI: \u201315.5, \u20134.6) incremental change per 10-year age increase at Day 180 (P for age effect\u00a0=\u00a00.001). Women exhibited an 18.6% (95% CI: 6.3, 29.2) greater UACR reduction at Day 180 than men (P for sex effect\u00a0=\u00a00.008). These effects were independent of treatment; there was no interaction between age (P-interaction\u00a0=\u00a00.28) or sex (P-interaction = 0.46) on combination therapy treatment effect. Safety outcomes were consistent across all demographics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The UACR-lowering response of finerenone and empagliflozin scaled linearly with age (10% per decade) and sex (\u223c20% more among women). The benefit of combination therapy was independent of age and sex.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ndt\/gfag075","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T12:48:56Z","timestamp":1774615736000},"page":"2042-2052","source":"Crossref","is-referenced-by-count":1,"title":["Sexual dimorphism and age effects in CKD and type 2 diabetes in the CONFIDENCE trial"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8355-7100","authenticated-orcid":false,"given":"Rajiv","family":"Agarwal","sequence":"first","affiliation":[{"name":"Division of Nephrology, Richard L. Roudebush VA Medical Center & Indiana University School of Medicine , Indianapolis, IN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer B","family":"Green","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine Division of Endocrinology, Department of Medicine and Duke Clinical Research Institute, , Durham, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3126-3730","authenticated-orcid":false,"given":"Hiddo J L","family":"Heerspink","sequence":"additional","affiliation":[{"name":"University Medical Center Groningen, University of Groningen Department of Clinical Pharmacy and Pharmacology, , Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes F E","family":"Mann","sequence":"additional","affiliation":[{"name":"KfH Kidney Centre , Munich ,","place":["Germany"]},{"name":"Friedrich Alexander University Department of Nephrology & Hypertension, , Erlangen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6228-6521","authenticated-orcid":false,"given":"Janet B","family":"McGill","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Metabolism & Lipid Research, Washington University in St. Louis, School of Medicine , St. Louis, MO ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy K","family":"Mottl","sequence":"additional","affiliation":[{"name":"University of North Carolina Kidney Center, UNC School of Medicine , Chapel Hill, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7401-2934","authenticated-orcid":false,"given":"Masaomi","family":"Nangaku","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8324-3275","authenticated-orcid":false,"given":"Julio","family":"Rosenstock","sequence":"additional","affiliation":[{"name":"Velocity Clinical Research at Medical City , Dallas, TX ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0885-1953","authenticated-orcid":false,"given":"Muthiah","family":"Vaduganathan","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlie","family":"Scott","sequence":"additional","affiliation":[{"name":"Clinical Statistics and Analytics, Bayer US LLC , Whippany, NJ 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