title: Developing Treatments for Chronic Kidney Disease in the 21st Century.
abstract: Chronic kidney disease (CKD) is a lethal and rapidly increasing burden on society. Despite this, there are relatively few therapies in development for the treatment of CKD. Several recent costly phase 3 trials have failed to provide improved renal outcomes, diminishing interest in pharmaceutical investment. Furthermore, poor patient, physician, and payer awareness of CKD as a diagnosis has contributed to slow trial enrollment and successful implementation of these trials. Nevertheless, several therapeutics remain in development for the treatment of CKD, including mineralocorticoid-receptor antagonists, sodium/glucose cotransporter 2 inhibitors, anti-inflammatory drugs, and drugs that mitigate oxidative injury. Success of future CKD therapeutic trials will depend not only on improved understanding of disease pathogenesis, but also on improved trial enrollment rates, through increasing awareness of this disease by the public, policy makers, and the greater medical community.
authors.affiliation: Biotechnology Discovery Research, Eli Lilly and Company, Indianapolis, IN. Electronic address: breyer_matthew@lilly.com.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Breyer
authors.affiliation: Renal Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Katalin
authors.initials: K
authors.lastname: Susztak
mesh_terms: D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000077868:Atrasentan; D001559:Benzhydryl Compounds / Q000627:therapeutic use; D000068896:Canagliflozin / Q000627:therapeutic use; D003928:Diabetic Nephropathies / Q000188:drug therapy*; D055808:Drug Discovery; D065128:Endothelin Receptor Antagonists / Q000627:therapeutic use*; D005960:Glucosides / Q000627:therapeutic use; D006025:Glycosaminoglycans / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D009828:Oleanolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D018384:Oxidative Stress; D011733:Pyridoxamine / Q000031:analogs & derivatives / Q000627:therapeutic use; D011759:Pyrrolidines / Q000627:therapeutic use; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy*; D000077203:Sodium-Glucose Transporter 2 Inhibitors
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000893:Anti-Inflammatory Agents; D001559:Benzhydryl Compounds; D065128:Endothelin Receptor Antagonists; D005960:Glucosides; D006025:Glycosaminoglycans; D007004:Hypoglycemic Agents; D000451:Mineralocorticoid Receptor Antagonists; D011759:Pyrrolidines; D000077203:Sodium-Glucose Transporter 2 Inhibitors; D000068896:Canagliflozin; D011733:Pyridoxamine; D009828:Oleanolic Acid; C007858:glucuronyl glucosamine glycan sulfate; C445068:bardoxolone methyl; C570240:empagliflozin; D000077868:Atrasentan; C570561:pyridoxamine dihydrochloride
keywords: Angiotensin; Diabetic nephropathy; SGTL2; inflammation; renal outcomes