What is the Latest Treatment for Chronic Kidney Disease?
Chronic kidney disease (CKD) affects more than 37 million Americans. This is a significant concern that often progresses silently. It is particularly worrisome if you’re on the receiving end of this diagnosis or your loved one. But, while there is no cure for CKD, the advancements in treatment offer hope to patients by slowing down its progression and in managing symptoms effectively.
Understanding what is the latest treatment for chronic kidney disease is crucial because it provides pathways to better health and an improved quality of life. Moreover, early intervention can make a substantial difference in outcomes, emphasizing the importance of staying informed about the most current therapeutic options.
Key Insights
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CKD affects over 37 million Americans and is a progressive condition with no cure, but treatments can slow its progression.
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New treatments like Farxiga, SGLT2 inhibitors, ARNIs, and GLP-1 agonists reduce kidney decline and cardiovascular risks.
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Lifestyle changes (diet, exercise, blood pressure control, quitting smoking) are critical for managing CKD.
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Advanced CKD may require dialysis or a kidney transplant, each with specific benefits and risks.
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Ongoing clinical trials, like EASi-KIDNEY, are exploring new therapies to improve CKD outcomes.
What is Chronic Kidney Disease (CKD)?
CKD is a condition where your kidneys gradually lose their ability to filter waste and excess fluid from your blood. This vital function keeps your body in balance. So when the kidneys are not working as they should, toxic waste can build up and can lead to serious health problems.
The primary causes of CKD are:
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Hypertension (high blood pressure)
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Diabetes
These conditions can damage the tiny vessels in the kidneys over time. Additionally, other factors can also increase the risk, such as:
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Heart disease
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Obesity
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Family history of kidney failure
Symptoms of CKD often develop slowly and can be subtle in the early stages, making early detection challenging. These can include:
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Fatigue
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Swelling in the legs, ankles, and feet
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Changes in urination
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Muscle cramps
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Difficulty concentrating (mental fog)
About 1 in 7 adults have CKD in the United States and as many as 90% of them are unaware they have it. Therefore, early diagnosis and management are essential to slow the progression of the disease and prevent complications.
What are the Stages of CKD?
CKD is categorized into five stages, primarily based on your glomerular filtration rate (GFR), which measures how well your kidneys are filtering blood. A higher GFR means your kidneys are functioning better. Understanding the stages of CKD is important for managing the condition and planning appropriate treatment.
The following outlines these stages for your overview:
STAGE 1
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GFR 90 or higher
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This is the initial stage
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Kidney damage is present but GFR is still normal or high
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Often shows no symptoms
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Diagnosis may come from incidentally finding protein in your urine, which highlights at-home urine test strips because these may be helpful in early diagnosis
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Management is focused in controlling underlying conditions like high blood pressure and diabetes to protect your kidneys
STAGE 2
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GFR 60-89
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Kidney function is mildly reduced
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Signs of kidney damage are evident
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Symptoms are usually absent
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Early interventions like lifestyle adjustments and medications are key to slow down the progression
STAGE 3
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GFR 30-59
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Indicates moderate kidney function
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Symptoms may start to appear including:
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Fatigue
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Swelling
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Changes in urination
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Often divided into 3a (GFR 45-59) and 3b (GFR 30-44)
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Treatment at this point is focused in managing complications like anemia and bone disease
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Control of underlying issues continues
STAGE 4
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GFR 15-29
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At this severe stage, kidney function is markedly reduced
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Complications are more common and more pronounced
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Preparations begin for treatment options like dialysis or kidney transplant
STAGE 5
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GFR less than 15
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The final stage of CKD
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It indicates kidney failure
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At this point, your kidneys are no longer able to effectively filter toxic waste products from your body
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Dialysis or a kidney transplant is necessary to sustain life
What are the Common Treatments for CKD?
When managing chronic kidney disease, a range of common treatments are employed to slow its progression and manage symptoms. These treatments aim to preserve kidney function for as long as possible and improve your overall well-being.
The following highlights several standard approaches:
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Medications: Doctors often prescribe medications that will control your blood pressure, reduce the amount of protein in the urine, and manage other complications. These medications are prescribed to protect the kidneys and lower the blood pressure at the same time. These could include:
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ACE (angiotensin-converting enzyme) inhibitors
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ARBs (angiotensin receptor blockers)
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Diuretics may be prescribed to reduce the swelling
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Medications to control cholesterol levels are also common
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Lifestyle changes: These are basic principles of CKD management. These changes significantly impact the disease’s progression and help you feel better. This includes:
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Dietary adjustments
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Regular physical activity
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Maintaining a healthy weight
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Advanced options: For patients with advanced CKD, dialysis or a kidney transplant may be necessary. Dialysis is a medical procedure that removes toxic waste products and excess fluid from the blood when the kidneys can no longer do so. It is done via a machine. A kidney transplant is a surgical procedure that involves removing the diseased kidney and placing a healthy replacement from a donor to your body.
Each treatment plan isn’t the same for all. It varies on a case to case basis, considering the stage of the CKD, overall health, and personal preferences. The goal is always to slow the disease’s progression, control the symptoms, and improve your quality of life.
What are the Newest Treatments for CKD in 2025?
The landscape of CKD management is constantly evolving, with new therapies offering improved outcomes for patients. These innovations focus on not only slowing disease progression but also addressing associated cardiovascular risks. The FDA has been active in approving new medications, while ongoing clinical trials continue to explore promising avenues.
How Does Farxiga Treat CKD?
Dapagliflozin (Farxiga) is a medication that has made a huge impact in the treatment of CKD. It belongs to a drug class known as SGLT2 inhibitors. Its primary mechanism involves reducing glucose reabsorption in the kidneys. It leads to an increased glucose excretion in the urine.
More than its effects on blood sugar, dapagliflozin has shown significant benefits in slowing kidney function decline. It reduces cardiovascular events, like heart failure hospitalization. It is generally well-tolerated by many. But potential side effects may include dehydration and urinary tract infections. However, it is not prescribed to all patients with CKD but only for eligible ones. They are often those with or without type 2 diabetes.
In the study published in the New England Journal of Medicine, patients who were prescribed dapagliflozin with heart failure and reduced ejection fraction had lower worsening incidents and mortality compared to those who received placebo at 13.7% and 9.6%, respectively.
What are SGLT2 Inhibitors and Their Role in CKD?
SGLT2 inhibitors, including medications like dapagliflozin (Farxiga) and empagliflozin (Jardiance), are a class of drugs that were initially developed for type 2 diabetes. However, research has revealed their remarkable benefits in protecting the kidneys.
They work by blocking the reabsorption of glucose in the kidneys, which could lead to an increased glucose excretion. This action not only helps control the blood sugar levels but also lowers the pressure within the kidney’s filtering units. As a result, it protects the kidney function. It has been shown that these medications reduce albuminuria, which is a marker of kidney damage, and slow down the progression of CKD.
What are ARNIs and How Do They Help Manage CKD?
ARNIs stand for angiotensin receptor-neprilysin inhibitors. These are a class of drugs that combine an ARB with a neprilysin inhibitor. Sacubitril/valsartan (Entresto) is a prominent example. These medications work by blocking the effects of certain hormones that can bring harm to the heart and kidneys. They also increase the levels of natural substances that relax the blood vessels while reducing sodium and water retention.
In CKD, ARNIs have shown promise in reducing proteinuria, a key indicator of kidney damage. Evidence shows that ARNIs offer benefits more than the traditional ARBs and ACE inhibitors, specifically in patients with heart failure and CKD.
What are GLP-1 Agonists and Their Benefits for CKD?
GLP-1 agonists are primarily known for their use in the control of type 2 diabetes and promoting weight loss. Examples of this drug class include:
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Semaglutide (Ozempic)
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Dulaglutide (Trulicity)
However, emerging research indicates that these medications also offer significant benefits for patients with CKD.
These medications work by mimicking the effects of a natural hormone that helps in regulating blood sugar and appetite. For CKD patients, GLP-1 agonists have been shown to reduce albuminuria and may slow the decline of kidney function. Their ability to improve glycemic control and reduce cardiovascular risk factors makes them a valuable addition to the CKD treatment regimen.
What Lifestyle Changes Can Help Manage CKD?
More than medications, daily habits can play a vital role in slowing down the CKD progression and improving overall health These changes are often the first line of defense and continue to be important throughout all stages of the disease.
How Does Diet Affect CKD?
Diet is a cornerstone of CKD management. Eating a kidney-friendly diet can significantly reduce the strain on your kidneys. This often means a low-salt (sodium) intake, typically less than 2.3 grams per day, to help control blood pressure and fluid retention.
Also, depending on your CKD stage, a low protein diet may be recommended to reduce the workload on your kidneys. But it is equally important to get enough protein to maintain muscle mass.
Specific recommendations often include kidney-friendly foods like:
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Berries
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Cabbage
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Fish
You may consult a registered dietitian who specializes in kidney disease is highly recommended so you can create a meal plan tailored solely for you.
What Role Does Exercise Play in Managing CKD?
Regular exercise offers several benefits for people with CKD. It includes:
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Improving cardiovascular health
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Weight management
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Boosting energy levels
Activities like walking, swimming, or cycling are often recommended. But it’s important that you start slowly and gradually increase in intensity while always listening to your body’s needs.
Staying hydrated is also crucial but you should discuss appropriate fluid intake with your doctor.
How Important is Blood Pressure Control in CKD?
High blood pressure is both a cause and effect of CKD, which accelerates kidney damage. Therefore, it is important to maintain the target blood pressure, which is below 130/80 mmHg. This involves combining lifestyle changes and medications like ACE inhibitors or ARBs.
You should also regularly monitor your blood pressure at home and follow-up with your doctor periodically.
Can Quitting Smoking Help Slow CKD Progression?
Yes, quitting smoking can significantly improve kidney health and overall well-being.
Smoking significantly causes harm to blood vessels throughout the body, including those in the kidneys, which worsens CKD progression. When you quit smoking, it can reduce the risk of heart attack and stroke that are common complications for CKD patients. Nicotine replacement therapy and enrollment to support groups can aid in the cessation.
When is Dialysis or a Kidney Transplant Needed for CKD?
If you have CKD, dialysis and kidney transplantation are advanced treatments that become necessary when the kidneys no longer do its job in adequate waste filtration and excess fluid elimination from the blood. This is especially true in stage 5 CKD where the GFR is less than 15. At this point, known as end-stage renal disease (ESRD), medical or even surgical intervention is crucial to sustain life.
Dialysis is a procedure that uses a machine to filter the blood and bypasses the function of the failing kidneys. There are two main types:
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Hemodialysis–The blood is filtered outside of the body via a machine in a dialysis center or at home several times in a week, depending on the frequency advised by your doctor.
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Peritoneal dialysis–This procedure uses the lining of your abdomen (peritoneum) to filter your blood inside your body. A special fluid is then introduced into your abdomen, which absorbs waste products and excess fluids before it is drained. This procedure may be done at home, which adds flexibility and convenience.
Kidney transplantation is another advanced intervention, which involves surgery by replacing the diseased kidney with a healthy one from a donor. The replacement may be from a living donor (often from a friend or family member) or from a deceased donor.
A successful transplant can offer a better quality of life and longer survival compared to long-term dialysis. However, this involves major surgery, lifelong immunosuppressant medications to prevent rejection, and potential risks. Success rates for kidney transplants are generally high, providing a new hope for many patients.
But the decision between dialysis and transplant, or even which type of dialysis is used, depends on various factors including a comprehensive discussion with your doctor, your overall health, lifestyle, and personal preferences.
Are There Any Experimental Treatments for CKD?
Yes, the field of kidney disease research is ever dynamic and constantly evolving in the hope of finding new avenues to improve patient outcomes. Clinical trials play a pivotal role in bringing these potential treatments from mere laboratory experiments to patients who need them. These trials investigate new medications, interventions, and approaches to the management of CKD. Thus, it offers new hope for further advancements.
One promising area of research involves vicadrostat, which is a drug investigated in trials like EASi-KIDNEY. Vicadrostat aims to address anemia in CKD patients by regulating erythropoietin (EPO) production. EPO is a hormone that’s essential for red blood cell formation.
These experimental treatments are still in various stages of development, and their long-term efficacy and safety are being carefully evaluated. Participation in clinical trials can offer access to these innovative therapies. But it's important to discuss the potential benefits and risks with your healthcare provider.
Related Resources
Stages of Chronic Kidney Disease. Know the CKD Symptoms
How to Protect Your Kidneys? Kidney Health Guide
Quick Summary Box
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CKD affects over 37 million Americans and is a progressive condition with no cure, but treatments can slow its progression.
-
New treatments like Farxiga, SGLT2 inhibitors, ARNIs, and GLP-1 agonists reduce kidney decline and cardiovascular risks.
-
Lifestyle changes (diet, exercise, blood pressure control, quitting smoking) are critical for managing CKD.
-
Advanced CKD may require dialysis or a kidney transplant, each with specific benefits and risks.
-
Ongoing clinical trials, like EASi-KIDNEY, are exploring new therapies to improve CKD outcomes.
References
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