Investigational new drugs for the treatment of chronic renal failure: an overview of the literature

ABSTRACT

Introduction

Chronic kidney disease (CKD) is widespread throughout the world, with a high social and health impact. It is considered a ‘silent killer’ for its sudden onset without symptoms in the early stages of the disease. The main goal of nephrologists is to slow the progression of kidney disease and treat the associated symptoms with a range of new medications.

Areas covered

The aim of this systematic review is to analyze the new investigational drugs for the treatment of chronic renal failure. Data were obtained from the available scientific literature and from the ClinicalTrials.gov website.

Expert opinion

Among the drugs currently being researched, SGLT2 inhibitors appear to be the most promising drugs for the treatment of CKD, has they have slower progression of CKD and protection of cardiorenal function. An important role in the future of CKD treatment is played by autologous cell-therapy, which appears to be a new frontier in the treatment of CKD. Other therapeutic strategies are currently being investigated and have been shown to slow the progression of CKD. However, further studies are needed to determine whether these approaches may offer benefits in slowing the progression of CKD in the near future.

KEYWORDS:

• CKD
• chronic kidney disease
• novel treatments
• HIF inhibitors
• SGLT2i
• diabetic kidney disease
• renal failure

Article highlights

• Chronic Kidney Disease (CKD) is a worldwide problem due to its social and health impact.

• For many years, there were few effective drugs to treat CKD and slow its progression.

• A major breakthrough in the treatment of anemia associated with CKD is the formulation of HIF-PH inhibitors, which have been shown in many studies to be non-inferior to conventional ESAs and effective in increasing hemoglobin levels in patients with CKD compared to placebo. The most promising and effective therapy for the treatment of CKD are the SGLT2 inhibitors. The DAPA-CKD trial has shown that Dapagliflozin is able to produce a slower reduction in eGFR and slower progression of CKD compared to placebo, with a low number of cardiorenal events compared to placebo. Other studies have shown the same results, and in 2021 the European Medicines Agency (EMA) has approved Dapagliflozin for the treatment of CKD in adults, regardless of Type 2 Diabetes.

• A variety of therapies are currently being investigated that show good results in reducing the progression of CKD. However, further research is needed to determine whether these approaches can continue to provide benefits in delaying the progression of CKD.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.