March encompassed a number of key updates in the nephrology landscape, including revised clinical practice guidelines from Kidney Disease: Improving Global Outcomes (KDIGO), phase 3 clinical trial data on emerging therapies for chronic kidney disease (CKD) and IgA nephropathy (IgAN), and featured content examining the International Society of Glomerular Disease (ISGD)'s latest research advances alongside a deep dive into how neighborhood disadvantage drives kidney disease risk and progression.

In this edition, KDIGO announces a focused update to its 2024 CKD guideline, spotlighting newer pharmacologic agents in the management of CKD progression, including the nonsteroidal mineralocorticoid receptor antagonist finerenone, which has now demonstrated statistically significant eGFR slope improvement in nondiabetic CKD populations in the phase 3 FIND-CKD trial. In IgAN, povetacicept achieved a 52% reduction in urine protein-to-creatinine ratio (UPCR) versus baseline in the RAINIER trial's 36-week interim analysis, reinforcing the therapeutic potential of BAFF/APRIL dual inhibition.

Beyond clinical trial data, HCPLive examines the intersection of social determinants of health and CKD risk, specifically how neighborhood disadvantage may drive disease burden in ways that biomarkers alone cannot capture, alongside a special report from the International Society of Glomerular Disease (ISGD) on the transformative scientific advances reshaping our biological understanding of glomerulonephritis and related conditions over the past five years.

Guideline Updates

KDIGO Launches Focused Update to 2024 CKD Guideline on Emerging Therapies

KDIGO announced a formal update to the 2024 Clinical Practice Guideline for the Evaluation and Management of CKD, one of the most widely used global resources for CKD evaluation and management. The update will focus on Chapter 3, "Delaying CKD progression and managing its complications," with particular emphasis on medical management using newer therapies in light of the evolving therapeutic landscape.

Trial News

Finerenone Proves CKD Benefit Extends Beyond Diabetes in FIND-CKD

Bayer announced the phase 3 FIND-CKD trial evaluating finerenone (Kerendia) in adult patients with nondiabetic CKD met its primary endpoint, demonstrating a statistically significant improvement in eGFR slope versus placebo over 32 months. The company indicated it planned to submit the data to the US Food and Drug Administration (FDA) to seek a label expansion into this patient population, which would represent the broadest application of the agent to date across a CKD program spanning more than 20,000 patients in phase 3 trials.

RAINIER: Povetacicept Reduces Proteinuria By 52.0%

Povetacicept met its primary and secondary endpoints in RAINIER, an ongoing phase 3 trial evaluating adults with IgA nephropathy (IgAN), according to a 36-week interim analysis. Vertex Pharmaceuticals announced positive results where povetacicept showed a 52.0% reduction in urine protein to creatinine ratio (UPCR) compared to baseline, with a statistically significant and clinically meaningful 49.8% UPCR reduction compared to placebo (P < .0001).

Featured Content

Crisis Point: The Cause and Calamity, Neighborhood Disadvantage and Kidney Disease

Clinicians often thought of healthcare as having a problem and a solution, but this Crisis Point examined what was going on underneath the surface. With the rising threat of chronic kidney disease, more was at stake than the values measurable in a lab, this piece focused on the detrimental problem of neighborhood disadvantage as both the cause and the calamity of kidney disease.

ISGD and the Fastest 5 Years in Glomerular Disease

For experts from ISGD, the last 5 years were the fastest and most dynamic period in glomerular disease. In this special report, Barbara Gillespie, MD, an adult nephrologist at the University of North Carolina and Chief Medical and Strategy Officer at ISGD, and Toby Huber, MD, head of Internal Medicine at Hamburg-Eppendorf in Germany and founding president of ISGD, broke down the scientific advances and how they revolutionized biological understanding of glomerular diseases.