{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T10:05:11Z","timestamp":1789380311537,"version":"build-2803163510"},"reference-count":25,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and hypothesis<\/jats:title>\n                    <jats:p>Diabetes mellitus type 2 (T2DM) is the primary driver of chronic kidney disease (CKD). Renin\u2013angiotensin\u2013aldosterone system inhibitors (RAASi) represent basic therapy for CKD in T2DM. Recent studies demonstrated renal benefits of sodium\u2013glucose cotransporter-2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP1-RAs), but data on direct comparisons and potential additive effects of their combination remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using data from the US Collaborative Network in TriNetX, we analyzed patients with T2DM, CKD, and estimated glomerular filtration rate (eGFR) between 20 and 60 ml\/min. A target trial emulation with propensity score matching evaluated different drug combinations in first-user design versus RAASi monotherapy. Primary endpoint was all-cause mortality. Secondary outcomes included a composite endpoint of all-cause mortality and major adverse kidney events (MAKE), and MAKE as a distinct endpoint. MAKE was defined as CKD stage 5, end-stage renal disease, eGFR\u00a0&amp;lt;15 ml\/min, or need for renal replacement therapy. Kaplan\u2013Meier analysis was used for survival analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified n\u00a0=\u00a019 139 patients with T2DM, an eGFR between 20 and 60ml\/min and already established RAASi treatment. RAASi combined with SGLT-2i [adjusted hazard ratio (aHR) 0.602, 95% confidence interval (CI) 0.528\u20130.686] or GLP1-RA (aHR 0.597, 95% CI 0.507\u20130.702) reduced mortality compared to RAASi monotherapy. Triple therapy showed the greatest mortality reduction (aHR 0.317, 95% CI 0.234\u20130.429). Secondary endpoints favored dual therapy over RAASi monotherapy, with triple therapy providing the strongest risk reduction for both composite endpoint (aHR 0.414, 95% CI 0.328\u20130.524) and MAKE (aHR 0.509, 95% CI 0.374\u20130.693).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SGLT-2i and GLP1-RA independently improve outcomes in T2DM patients on RAASi treatment. Triple therapy was associated with lower risk for mortality and renal outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ndt\/gfag198","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:40:28Z","timestamp":1787841628000},"source":"Crossref","is-referenced-by-count":0,"title":["Comparative effectiveness of combination therapy in patients with chronic kidney disease and diabetes mellitus type 2 using real-world data"],"prefix":"10.1093","author":[{"given":"Janis","family":"Casper","sequence":"first","affiliation":[{"name":"Department of Nephrology and Hypertension, Hannover Medical School , Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0629-325X","authenticated-orcid":false,"given":"Julian","family":"Doricic","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, Hannover Medical School , Hannover 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