Targeting Inflammation in CKD

Area of Science:

• Immunology
• Nephrology
• Cardiology

Background:

• Chronic systemic inflammation, driven by innate immune activation, significantly contributes to chronic kidney disease (CKD) and its complications, including atherosclerosis and cardiovascular disease (CVD).
• Targeting inflammatory pathways represents a novel therapeutic strategy investigated over the last 15 years to mitigate CVD risk in CKD patients and slow kidney disease progression.

Purpose of the Study:

• To review current and emerging anti-inflammatory therapeutic strategies for managing chronic kidney disease and associated cardiovascular risks.
• To highlight ongoing clinical trials investigating novel targets within inflammatory pathways for CKD patients.

Main Methods:

• Review of recent and ongoing clinical trials focused on targeting specific inflammatory mediators and pathways in patients with chronic kidney disease.
• Examination of therapies including interleukin-1 (IL-1) and IL-1 receptor inhibitors, interleukin-6 (IL-6) and IL-6 receptor inhibitors, NLRP3 inflammasome inhibitors, nuclear factor erythroid 2-related factor 2 (Nrf2) activators, and senolytics.

Main Results:

• Several anti-inflammatory targets, including IL-1, IL-6, NLRP3 inflammasome, Nrf2, and senolytics, are under active investigation in clinical trials for CKD patients.
• These trials aim to assess the efficacy of these novel therapies in reducing atherosclerotic cardiovascular disease risk and slowing the progression of kidney disease.

Conclusions:

• Targeting inflammatory pathways offers a promising avenue for managing CKD and its cardiovascular complications.
• Despite promising research, challenges and considerations remain for the clinical implementation of these anticytokine therapies, pending results from ongoing Phase 3 trials.