Chronic kidney disease (CKD) and acute kidney injury (AKI) remain significant global health challenges, requiring continuous advancements in therapeutic strategies. Recent pharmacological innovations aim to improve outcomes in renal diseases by targeting underlying pathophysiological mechanisms and reducing disease progression. Advances in renin-angiotensin-aldosterone system (RAAS) modulation, particularly with angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), and novel agents like neprilysin inhibitors, have reshaped the management of hypertension and proteinuria in CKD. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have emerged as a groundbreaking therapy for renal and cardiovascular protection in diabetic and non-diabetic CKD patients. Furthermore, endothelin receptor antagonists have shown promise in reducing proteinuria and slowing CKD progression. In AKI management, the focus has shifted towards early detection with new biomarkers and the development of targeted therapeutic approaches, including cell therapies and renoprotective agents. Antioxidant therapies are also being explored for their potential to mitigate oxidative stress, a key contributor to kidney damage. Emerging areas of interest include gene therapy, nanomedicine for targeted renal drug delivery, and the application of artificial intelligence in drug discovery. These advancements hold significant promise for transforming renal disease management and improving patient outcomes.
Chronic kidney disease, Sodium-glucose cotransporter-2, Nanomedicine, Angiotensin II receptor blockers, Hypertension.
Agarwal, R., Kolkhof, P., Bakris, G., Bauersachs, J., Haller, H., Wada, T., & Zannad, F. (2021). Steroidal and non-steroidal mineralocorticoid receptor antagonists in cardiorenal medicine. European Heart Journal, 42(2), 152–161.
Budde, K., Vincenti, F., Wiseman, A., et al. (2018). Novel immunosuppressive therapies: Focus on costimulation blockade and anti-CD40. Transplant International, 31(7), 759–777.
Chen, Y. Y., Chen, X. G., & Zhang, S. (2022). Druggability of lipid metabolism modulation against renal fibrosis. Acta Pharmacologica Sinica, 43(3), 505–519.
Cheungpasitporn, W., Lentine, K. L., Tan, J. C., Kaufmann, M., Caliskan, Y., Bunnapradist, S., ... & Axelrod, D. A. (2021). Immunosuppression considerations for older kidney transplant recipients. Current Transplantation Reports, 8, 100–110.
Connolly, S. J., Eikelboom, J. W., Bosch, J., et al. (2019). Rivaroxaban in patients with atherosclerotic disease and moderate renal dysfunction: The COMPASS trial. Circulation, 139(7), 770–778.
Ekins, S., Puhl, A. C., Zorn, K. M., et al. (2021). Exploiting AI and machine learning for drug discovery in nephrology. Clinical Pharmacology & Therapeutics, 109(4), 988–1002.
Hardinger, K. L., Brennan, D. C., & Klein, C. L. (2013). Selection of induction therapy in kidney transplantation. Transplant International, 26(7), 662–672.
Heerspink, H. J., Stefánsson, B. V., Correa-Rotter, R., Chertow, G. M., Greene, T., Hou, F. F., ... & Wheeler, D. C. (2020). Dapagliflozin in patients with chronic kidney disease. New England Journal of Medicine, 383(15), 1436–1446.
Kasuno, K., Yodoi, J., & Iwano, M. (2022). Urinary thioredoxin as a biomarker of renal redox dysregulation and a companion diagnostic to identify responders to redox-modulating therapeutics. Antioxidants & Redox Signaling, 36(13), 1051–1065.
Larsen, C. P., Pearson, T. C., Adams, A. B., Tso, P., Shirasugi, N., Strobert, E., ... & Peach, R. J. (2005). Rational development of LEA29Y (belatacept), a high-affinity variant of CTLA4-Ig with potent immunosuppressive properties. American Journal of Transplantation, 5(3), 443–453.
Leong, D. P., Joseph, P. G., McKee, M., Anand, S. S., Teo, K. K., Schwalm, J. D., & Yusuf, S. (2017). Reducing the global burden of cardiovascular disease, part 2: Prevention and treatment of cardiovascular disease. Circulation Research, 121(6), 695–710.
Lippi, G., Mattiuzzi, C., & Cervellin, G. (2018). Thrombosis and hemostasis in end-stage renal disease: Role of antiplatelet therapy. Seminars in Thrombosis and Hemostasis, 44(4), 345–353.
Mayer, A. D., Dmitrienko, S., Nashan, B., et al. (2001). Multinational trial of the humanized anti–interleukin-2 receptor monoclonal antibody daclizumab to prevent acute rejection in renal transplantation: A pooled analysis of three randomized studies. Journal of the American Society of Nephrology, 12(10), 2409–2416.
Moreno, J. A., Gomez-Guerrero, C., Mas, S., et al. (2020). Nanomedicine for the treatment of kidney diseases. Kidney International, 98(1), 55–65.
Nashan, B., & Citterio, F. (2012). Wound healing complications and the use of mTOR inhibitors in kidney transplantation: A critical review of the literature. Transplantation, 94(6), 547–561.
Pattenden, R. J., Gutierrez-Dalmau, A., & Knight, S. R. (2020). Induction therapy in kidney transplantation. Transplantation Proceedings, 52(3), 692–699.
Perkovic, V., Jardine, M. J., Neal, B., et al. (2019). Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. New England Journal of Medicine, 380(24), 2295–2306.
Pitt, B., Anker, S. D., Lund, L. H., Coats, A. J. S., Filippatos, G., Rossignol, P., ... & Butler, J. (2024). Patiromer facilitates angiotensin inhibitor and mineralocorticoid antagonist therapies in patients with heart failure and hyperkalemia. Journal of the American College of Cardiology, 84(14), 1295–1308.
Rangaswami, J., Bhalla, V., Blair, J. E. A., et al. (2019). Cardiorenal protection with SGLT-2 inhibitors: A scientific statement from the American Heart Association. Circulation, 140(15), 1257–1263.
Rodrigues, F., Andina, D., Sousa, E., et al. (2022). Gene and stem cell therapies: Future prospects in kidney diseases. International Journal of Molecular Sciences, 23(8), 205–212.
Sharma, A., & Chandraker, A. (2020). Emerging role of biomarkers in personalized immunosuppression for renal transplant recipients. Frontiers in Immunology, 11, 526–539.
Singh, A. K., Carroll, K., Perkovic, V., Solomon, S., Jha, V., Johansen, K. L., ... & McMurray, J. J. (2021). Daprodustat for the treatment of anemia in patients undergoing dialysis. New England Journal of Medicine, 385(25), 2325–2335.
Tonelli, M., & Riella, M. (2020). Emerging treatment strategies for hyperphosphatemia in chronic kidney disease. Clinical Journal of the American Society of Nephrology, 15(7), 1016–1023.
Tuttle, K. R., Bakris, G. L., & Bilous, R. W. (2021). Diabetic kidney disease: Advances in pathogenesis and therapeutics. Kidney International Supplements, 100(2), 208–217.
Vincenti, F., Charpentier, B., Vanrenterghem, Y., et al. (2010). A phase III study of belatacept-based immunosuppression regimens versus cyclosporine in renal transplant recipients (BENEFIT study). The Lancet, 376(9747), 773–783.
Vincenti, F., Larsen, C., Durrbach, A., et al. (2005). Costimulation blockade with belatacept in renal transplantation. New England Journal of Medicine, 353(8), 770–781.
Wheeler, D. C., & Toto, R. D. (2021). Advances in the treatment of chronic kidney disease: Current and future therapies. Kidney International Supplements, 11(3), 2–7.
Wilson, F. H., Chitale, D. A., & Patel, V. (2019). Precision nephrology: Integrating genomics into clinical practice. American Journal of Kidney Diseases, 73(6), 869–880.
Wong, C. X., Lau, D. H., & Sanders, P. (2021). Direct oral anticoagulants in chronic kidney disease: Safe and effective. Kidney International, 99(2), 276–285.
Xie, Y., Zhao, H., Chen, S., et al. (2022). Applications of artificial intelligence in kidney disease: From imaging to drug discovery. Kidney International, 102(1), 50–65.
Yao, X., Abraham, N. S., Sangaralingham, L. R., et al. (2017). Effectiveness and safety of direct oral anticoagulants versus warfarin in patients with chronic kidney disease: A retrospective cohort study. Annals of Internal Medicine, 167(7), 205–212.
Zhang, P., Ma, Y., Wang, L., et al. (2020). Nanomedicine and nanotechnology in the treatment of kidney diseases. Frontiers in Pharmacology, 11, 55–70.
Zhou, X., Wang, L., Chen, S., et al. (2021). Gene therapy for kidney diseases: Advances and challenges. Nature Reviews Nephrology, 17(5), 283–301.
Zou, H., Hastie, T., Tibshirani, R., et al. (2020). Artificial intelligence in nephrology: Machine learning and precision medicine. Nephrology Dialysis Transplantation, 35(9), 1538–1544.
