New renal drug development to face chronic renal disease

Solange Moll1, Matthias Meier, Ivan Formentini

  • 1University Hospital Geneva, Institute of Clinical Pathology , Geneva , Switzerland.

Insights

Renal drug development is now feasible, targeting inflammation and fibrosis pathways to combat chronic kidney diseases. New approaches and biomarkers promise to revolutionize future treatments for kidney disease.

Area of Science:

  • Nephrology
  • Pharmacology
  • Drug Development

Background:

  • Chronic kidney diseases (CKD) recognized by WHO in 2012 due to significant morbidity, mortality, and healthcare costs.
  • Current CKD treatment relies on 1980s-era antihypertensive drugs, highlighting an unmet medical need.
  • CKD presents a substantial market opportunity for pharmaceutical innovation.

Purpose of the Study:

  • To explain the current feasibility of developing novel therapeutics for renal diseases.
  • To focus on treatments targeting key pathogenic pathways in CKD.
  • To review advancements enabling effective renal drug development.

Main Methods:

  • Review of current scientific literature on renal drug development.
  • Analysis of therapeutic strategies targeting inflammation and fibrosis in CKD.
  • Examination of mechanisms driving CKD progression and organ function loss.

Main Results:

  • Multiple preclinical and clinical approaches are available for developing effective renal therapeutics.
  • Biomarkers are crucial for advancing drug development and understanding disease mechanisms.
  • Surrogate indications for rare diseases can accelerate clinical validation of therapeutic targets.

Conclusions:

  • Developing effective therapeutics for renal diseases is now plausible.
  • Biomarker relevance and use of surrogate indications can expedite clinical development.
  • These advancements hold the potential to revolutionize future CKD treatment paradigms.
Abstract

Related Concept Videos

Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
553
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
362
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
673
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
660
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area.
337
Renal Drug Excretion: Overview01:15

Renal Drug Excretion: Overview

As primary excretory organs, the kidneys maintain homeostasis by removing waste substances from the bloodstream. They comprise over a million units called nephrons, which serve as the kidney's functional units.
A nephron consists of two primary structures: the renal corpuscle and the renal tubule. The renal corpuscle contains the glomerulus, a network of capillaries where the first step of renal excretion, glomerular filtration, occurs. Blood pressure forces water, ions, and small molecules...
1.1K