Abstract:Objective To investigate the effect of Jinhu Gushen Formula on renal function in diabetic kidney disease (DKD) patients with massive proteinuria, and to evaluate its efficacy and safety. Methods A retrospective cohort stud ywas conducted on 88 DKD patients with massive proteinuria admitted to the Department of Endocrinology of the Affiliated Hospital of Qingdao University from June 2023 to June 2025. According to the treatment plan, the patients were divided into the Jinhu Gushen Formula group (n=43) and the finerenone group (n=45). Renal function indicators [urine albumin- to-creatinine ratio (UACR), serum creatinine, serum uric acid, estimated glomerular filtration rate (eGFR)] and safety indicators (serum potassium) between two groups of patients were compared. Results For DKD patients with massive proteinuria, the Jinhu Gushen Formula group demonstrated a lightly higher effective rate compared to the finerenone group, without significant statistical significance [88.37% (38/43) vs 77.78% (35/45), χ²=1.745, P= 0.186]. The serum uric acid level in the Jinhu Gushen Formula group was significantly lower than that in the finerenone group [ (340.51±87.06) μmol/L vs (383.96±90.04) μmol/L, t= 2.301, P= 0.024], and the rate of uric acid reduction was significantly greater in the Jinhu Gushen Formula group (4.88%±24.98% vs -9.66%±25.09%, t= 2.724, P= 0.008). In terms of safety, the serum potassium level in the Jinhu Gushen Formula group was significantly lower than that in the finerenone group [ (4.59±0.34) mmol/L vs (4.94±0.47) mmol/L, t= 2.719, P= 0.010], with a significantly lower rate of potassium elevation observed in the Jinhu Gushen Formula group (-0.22%±8.34% vs 9.23%±8.60%, t= 3.529, P= 0.001). Conclusion Jinhu Gushen Formula has a similar effect as finerenone in reducing UACR in DKD patients with massive proteinuria, and can better reduce their blood uric acid levels, with good safety.