<h4>Introduction</h4>This study evaluated the effectiveness and safety of an add-on treatment with finerenone as combination therapy in patients with diabetic kidney disease (DKD), an area where real-world data is limited.<h4>Materials and methods</h4>We retrospectively evaluated patients with DKD treated with sodium-glucose cotransporter 2 (SGLT-2) inhibitors and add-on finerenone, to assess the effectiveness and safety of the combination therapy (data collected between June 2021 and October 2024). This evidence concerns the gene SLC5A2 and diabetic kidney disease.