Emerging drugs for chronic kidney disease.
BACKGROUND
Chronic kidney disease (CKD) is a worldwide health problem. Despite remarkable headway in slowing the progression of kidney diseases, the incidence of end-stage renal disease (ESRD) is increasing in all countries with a severe impact on patients and society. The high incidence of diabetes and hypertension, along with the aging population, may partially explain this growth. Currently, the mainstay of pharmacological treatment for CKD, aiming to slow progression to ESRD are ACE inhibitors and angiotensin II receptor blockers for their hemodynamic/antihypertensive and anti-inflammatory/antifibrotic action. However, novel drugs would be highly desirable to effectively slow the progressive renal function loss.


METHODS
Through the search engines, PubMed and ClinicalTrial.gov, the scientific literature was reviewed in search of emerging drugs in Phase II or III trials, which appear to be the most promising for CKD treatment.


CONCLUSIONS
The great expectations for new drugs for the management of CKD over the last decade have unfortunately not been met. Encouraging results from preliminary studies with specific agents need to be tempered with caution, given the absence of consistent and adequate data. To date, several agents that showed great promise in animal studies have been less effective in humans.
S.Orsola University Hospital, Department of Experimental, Diagnostic and Speciality Medicine, Dialysis, Nephrology and Trasplantation Unit , Via Massarenti, 9, Bologna, 40138 , Italy sergio.stefoni@unibo.it.
Sergio
S
Stefoni
Giuseppe
G
Cianciolo
Olga
O
Baraldi
Mario
M
Iorio
Maria Laura
ML
Angelini
D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000818:Animals; D000077868:Atrasentan; D006025:Glycosaminoglycans / Q000627:therapeutic use; D006801:Humans; D011725:Pyridines / Q000627:therapeutic use; D011733:Pyridoxamine / Q000031:analogs & derivatives / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D011759:Pyrrolidines / Q000627:therapeutic use; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy*
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D006025:Glycosaminoglycans; D011725:Pyridines; D011743:Pyrimidines; D011759:Pyrrolidines; D011733:Pyridoxamine; C007858:glucuronyl glucosamine glycan sulfate; C484919:Avosentan; D000077868:Atrasentan; C570561:pyridoxamine dihydrochloride
albuminuria; bardoxolone; chronic kidney disease; end stage renal disease; endothelin receptor antagonist; paricalcitol; renin-angiotensin-aldosterone system