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Updates in chronic kidney disease management: A systematic review
Amina Ammar1,2, Stephanie B Edwin2, Rachel Whitney3
1Eugene Applebaum College of Pharmacy & Health Sciences, Wayne State University, Detroit, Michigan, USA.
Pharmacotherapy
|March 28, 2025
Summary
Emerging chronic kidney disease (CKD) treatments show promise. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are now a first-line therapy for CKD, with other agents considered based on patient needs.
Area of Science:
- Nephrology
- Pharmacology
- Internal Medicine
Background:
- Chronic kidney disease (CKD) presents a substantial global health burden.
- Current CKD management primarily relies on renin-angiotensin system inhibitors (RASi).
- There is a need for novel therapeutic strategies to improve CKD outcomes.
Purpose of the Study:
- To systematically review the efficacy and safety of emerging CKD therapies.
- To evaluate sodium-glucose cotransporter 2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1RA), finerenone, sacubitril/valsartan, and potassium binders.
- To assess evidence beyond traditional RASi for CKD management.
Main Methods:
- Systematic literature search of PubMed, Scopus, CINAHL Complete, and Web of Science Core Collection.
- Inclusion of experimental and observational studies in adult CKD patients.
- Risk of bias assessment using Cochrane RoB 2 and ROBINS-I tools.
Main Results:
- SGLT2 inhibitors demonstrate consistent, significant benefits in slowing CKD progression, establishing them as a first-line treatment alongside RASi.
- GLP-1 receptor agonists, finerenone, and sacubitril/valsartan show potential, with their use guided by patient comorbidities.
- Potassium binders may facilitate extended use of RASi therapy.
Conclusions:
- SGLT2 inhibitors are a cornerstone in modern CKD management.
- Individualized treatment approaches incorporating newer agents are essential for optimizing CKD care.
- Further research should focus on the comparative effectiveness and long-term safety of these emerging therapies.
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