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April 15, 2026The Journal of Clinical Endocrinology & Metabolism

Quadruple combination therapy with RASi, SGLT2i, nsMRA, and GLP-1RA provides independent cardiorenal protection in patients with chronic kidney disease and type 2 diabetes.

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Why the study?

Does combination GDMT (RASi, SGLT2i, nsMRA, GLP-1RA) improve cardiorenal risk reduction in patients with CKD and T2D?

Population

Patients with chronic kidney disease (CKD) and type 2 diabetes (T2D)

Design

Review

Key result

Quadruple combination therapy with RASi, SGLT2i, nsMRA, and GLP-1RA provides independent cardiorenal protection in patients with chronic kidney disease and type 2 diabetes.

Authors

MMMai MohsenTYTae Won YiLFLabib Imran Faruque

Discussion

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Overview

A proposed practical algorithm for implementing quadruple combination therapy (RASi, SGLT2i, nsMRA, GLP-1RA) aims to overcome clinical inertia and improve cardiorenal outcomes in patients with CKD and T2D.

Structured PICO

Does combination GDMT (RASi, SGLT2i, nsMRA, GLP-1RA) improve cardiorenal risk reduction in patients with CKD and T2D?

P
Population
Patients with chronic kidney disease (CKD) and type 2 diabetes (T2D)
I
Intervention
Combination guideline-directed medical treatments (GDMT) including renin-angiotensin system inhibitors (RASi), sodium glucose cotransporter-2 inhibitors (SGLT2i), nonsteroidal mineralocorticoid receptor antagonists (nsMRA), and glucagon-like peptide-1 receptor agonists (GLP-1RA)

A proposed practical algorithm for implementing quadruple combination therapy (RASi, SGLT2i, nsMRA, GLP-1RA) aims to overcome clinical inertia and improve cardiorenal outcomes in patients with CKD and T2D.

Cite This Study

Mohsen et al. (2026) studied this question. Quadruple combination therapy with RASi, SGLT2i, nsMRA, and GLP-1RA provides independent cardiorenal protection in patients with chronic kidney disease and type 2 diabetes.

synapsesocial.com/papers/69df2ba0e4eeef8a2a6b0a74https://doi.org/10.1210/clinem/dgag163
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Comparative Effectiveness of Combination Therapy in Patients with Chronic Kidney Disease and Diabetes mellitus Type 2 using Real World Data2026
  2. 2Repurposing Diabetes Therapies in CKD: Mechanistic Insights, Clinical Outcomes and Safety of SGLT2i and GLP-1 RAs2025
  3. 3Incretin-based therapies in diabetic kidney disease: toward integrated cardio-kidney-metabolic disease modification2026
  4. 4Characteristics and cardio-renal outcomes in CKD patients receiving guideline-directed therapy: insights from DISCOVER CKD2025
  5. 5Rapidly changing landscape of diabetic kidney disease management: recent advances and the road ahead2026