Chronic kidney disease (CKD) is a slow, progressive loss of kidney function that affects more than 10% of adults worldwide, often driven by diabetes and high blood pressure. Until recently, treatment mostly slowed progression rather than reversing it — but newer drug classes are changing that picture.
What's actually going on in research
SGLT2 inhibitors, first developed for diabetes, have shown they slow CKD progression across a wide range of patients regardless of whether they have diabetes, and are now considered a cornerstone of CKD management. Non-steroidal mineralocorticoid receptor antagonists like finerenone reduce both kidney and cardiovascular risk in diabetic CKD, and trials are testing their use in non-diabetic disease. Gene and RNA therapies targeting pathways that drive fibrosis and inflammation in the kidney are in early trials.
SGLT2 inhibitors
These oral diabetes drugs have proven kidney-protective effects beyond glucose control, and large trials are establishing their role as standard therapy across many CKD populations.
Mineralocorticoid antagonists
Non-steroidal mineralocorticoid receptor antagonists reduce kidney inflammation and scarring; trials are testing them in non-diabetic CKD and in combination with SGLT2 inhibitors.
Anti-fibrotic therapy
Several drugs targeting TGF-beta and other fibrosis-driving pathways are in early and mid-stage trials, aiming to halt the scarring that leads to kidney failure.
What to know before you search
Eligibility usually depends on eGFR range, degree of proteinuria (urine albumin-to-creatinine ratio), diabetes status, and current medications.
What types of trials are currently open
- Drug trials — Testing new medications to slow CKD progression, reduce protein in urine, or protect the heart and kidneys together.
- Dialysis trials — Comparing dialysis modalities, schedules, and membranes to improve outcomes for those with kidney failure.
- Transplant trials — Testing immunosuppression strategies and tolerance induction to improve kidney transplant longevity.
- Diet and lifestyle trials — Evaluating low-protein diets, sodium restriction, and exercise programs in slowing CKD.
- Observational studies — Tracking biomarkers and risk factors that predict faster CKD progression.
Recently added Chronic Kidney Disease trials
Improving Patient Assessment After Acute Kidney Injury (AKI)
The goal of this clinical trial is to improve patient care after acute kidney injury (AKI). It has three related parts. The main questions it aims to answer are: 1. Is creatinine or cystatin a more reliable assessment of kidney function after AKI? 2. What are the experiences of patients after AKI? 3. What interventions should be recommended to improve assessment and support of patients after AKI? Participants will be asked to do one or more of: * blood tests to measure kidney function in different ways * have measurement of their body composition * complete questionnaires about their symptoms * have an interview with a researcher about their experiences * discussion to develop an action plan based on findings
A Smart Phone Application to Improve Adoption of the 2024 Kidney Disease Improving Global Outcomes (KDIGO) Chronic Kidney Disease (CKD) Guidelines
The goal of this study is to establish whether use of a digital intervention can improve adherence and alignment with the Kidney Disease: Improving Global Outcomes (KDIGO) Chronic Kidney Disease (CKD) 2024 Guidelines. A subset of the study will focus on whether the intervention improves outcomes for young adults living with CKD, in the context of the imminent co-location of Children's Health Ireland on the St. James's Hospital campus. Young adults with CKD transitioning to adult services are recognised as a high-risk and vulnerable cohort, with many individuals unaware of increased cardiovascular risk and mortality¹². In response, and in the context of the co-location of Children's Health Ireland on the St. James's Hospital site, a young adult nephrology clinic has been established. The KDIGO CKD 2024 Guidelines identify transition as a period of increased risk and include recommendations regarding cardiovascular risk factor targets and the use of therapies known to delay CKD progression³. Electronic communication is a preferred method for accessing health information among many young adults⁴⁵ and aligns with Sláintecare digital health strategies⁶. A recently established, award-winning St. James's Hospital renal smartphone application is currently used by over 3,000 individuals living with CKD. The study aims to determine whether use of the application improves adherence to KDIGO guideline recommendations, with the objective of delaying CKD progression and associated complications. The application will support optimisation of care by signposting opportunities for evidence-based interventions (e.g., SGLT2 inhibitors, renin-angiotensin system inhibition) to healthcare providers. The application will also provide participants with tailored recommendations, reminders, educational materials, and collection of patient-reported outcome measures. Due to the diverse population and range of specialties at St. James's Hospital, the young adult clinic serves distinct subgroups, including individuals with sickle cell anaemia and survivors of cancer and haematological malignancies. These populations will be examined in the context of KDIGO guideline implementation, contributing to a limited international evidence base. This research evaluates an intervention designed to improve care for adults living with chronic kidney disease.
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