Decline is not inevitable.
A daily, evidence-graded view of everything moving in kidney research : the drugs that slow decline, the science of regeneration, and the mind-body work.
Strong new trial results point to better ways to slow a common kidney disease.
Today leaned heavily on IgA nephropathy, a common kidney disease, with strong late-stage trial data for two drugs, iptacopan and atacicept, that aim to slow kidney decline. A high-quality pooled analysis also looked at how dialysis fluid calcium relates to artery stiffness and heart risk. The rest was mostly observational work and preprints, including studies on diet, heat exposure, and diabetes drugs that protect the kidneys. Those point to interesting links but are not proof, so treat them as early signals rather than settled answers.
NephJC Short: 24-Month Iptacopan eGFR Data in IgA Nephropathy — NephJC
This is a journal club covering 24-month results for iptacopan, a drug for IgA nephropathy, a common kidney disease. It comes from APPLAUSE-IgAN, a large late-stage randomized trial, and shows the drug helped protect the kidney filtering rate (eGFR) over two years. This is a blog summary, but the underlying trial is strong evidence. Longer-term data like this suggests a real benefit for slowing kidney decline.
Comparison of Dialysate Calcium Concentrations and Arterial Stiffness in Dialysis Patients: A Network Meta-analysis
This pooled several studies of dialysis patients to compare different calcium levels in the dialysis fluid. It looked at how stiff the arteries became, which is a sign of heart risk. Pooling many studies makes the finding stronger. It suggests the calcium level used during dialysis may affect artery stiffness.
Attacking the Origin of IgAN: ORIGIN3 and Atacicept — NephJC
A large Phase 3 trial tested a drug called atacicept for IgA nephropathy, a common cause of kidney damage. The drug aims to calm the immune signals that drive the disease. The results were published in a major medical journal. A trial this large and carefully run carries real weight for how this disease may be treated.
Is TRPC6 inhibition for FSGS a trick or a treat? — NephJC
This was an early (phase 2) trial of a new drug, BI 764198, for FSGS, a disease that scars the tiny filters in the kidney and leaks protein into the urine. People were randomly given either the drug or a dummy pill (placebo), and the results were published in a major journal (the Lancet). An early trial like this tests whether a drug is safe and shows promise. It is a first step, not proof that the drug protects kidneys over the long run.
Heir to the Throne? Obinutuzumab in the membranous nephropathy MAJESTY trial — NephJC
This trial compared two treatments for primary membranous nephropathy, a disease where the kidney's filter is damaged and leaks protein into the urine. People were randomly assigned to get either obinutuzumab, an antibody given by drip, or tacrolimus, a pill that calms the immune system. It was a head-to-head test to see which better controls the disease, published in a top journal (NEJM). Because it is a mid-size trial, it shows which drug worked better here but does not settle long-term kidney survival.
Finerenone across the proteinuric CKD spectrum — NephJC
This is a journal club discussing finerenone, a drug that lowers protein in the urine and helps protect the kidneys. Two 2026 papers extended the evidence beyond diabetes, including a preplanned subgroup from a large trial called FIND-CKD focused on people with glomerular disease, a type of kidney damage. The exact number of people in that subgroup was not given here. Because it is a subgroup rather than the main trial result, treat it as promising but not final proof.
https://www.era-online.org/publications/causal-assessment-of-ckd-mbd-biomarker-alterations-on-ckd-progression-through-a-g-formula-analysis-in-the-equal-study/
This published study looked at whether changes in bone and mineral blood markers, such as phosphate, are tied to faster kidney decline in people with advanced kidney disease. Using data from the EQUAL study, it found a link between these markers and worsening kidney function. This is an observational study, so it shows a connection, not proof that the markers cause the decline.
Spectrum of Anti–Factor B-Associated Glomerular Diseases in Adults
Some people make an antibody that attacks a part of the immune system called factor B. This study looked at adults with that antibody and described the range of kidney filter diseases they had. It shows a link between the antibody and these diseases, not proof of cause.
Hepatic fibrosis severity assessed by FIB-4 index is independently associated with reduced kidney function in patients with metabolic dysfunction-associated steatotic liver disease: a nationwide multicenter study from Türkiye.
In people with fatty liver disease, those with worse liver scarring scores (measured by a test called FIB-4) tended to have lower kidney function. This was a large study across many centers in Türkiye. It shows a link between liver scarring and weaker kidneys, not proof that one causes the other.
Comparative effectiveness of finerenone versus steroidal mineralocorticoid receptor antagonists on sepsis-induced cardiomyopathy in patients with diabetic kidney disease: a real-world cohort study.
This study compared finerenone, a kidney and heart drug, with older water-pill-type drugs in people who have diabetic kidney disease. It looked at heart muscle trouble caused by severe infection (sepsis). Because it watched real-world records, it can show a link, not prove the drug caused the difference.
The HFpEF-ABA Score, Incident Heart Failure, and Finerenone in Chronic Kidney Disease with Type 2 Diabetes.
This work looked at a heart-failure risk score in people with kidney disease and type 2 diabetes, and where finerenone fits in. Finerenone is a drug that protects the kidneys and heart. The analysis can show links between the score and outcomes, but it does not prove cause.
Chronic kidney disease–mineral and bone disorder among maintenance hemodialysis patients in Addis Ababa, Ethiopia: prevalence, guideline adherence, complications, and quality of life
This looked at people on dialysis in Addis Ababa, Ethiopia. It measured how common bone and mineral problems are, a frequent dialysis complication, and how they affect daily life. Because it counts what is already happening, it shows a link, not cause. No treatment was tested.
Renal Outcomes of Triglyceride-Targeting Lipid-Lowering Therapies versus Statins in Patients with CKD
This compared kidney outcomes in people with kidney disease who took triglyceride-lowering drugs versus statins. Both are used to lower fats in the blood. Because it compares people already taking these drugs, it shows a link, not proof. It points at whether one type protects the kidneys more.
Blood pressure Time in Target Range and Clinical Outcomes in Chronic Kidney Disease
This studied people with kidney disease and how much of the time their blood pressure stayed in the target range. More time in range was linked to better health outcomes. This shows a link, not proof, but steady blood pressure control is known to protect kidneys over time.
Factors of Progression of Chronic Kidney Disease in Hospitalized Patients at Chud-ba in Parakou in 2026
This studied patients at a single hospital in Parakou, Benin, to find what makes kidney disease get worse. Because it is one hospital watching existing patients, it shows links, not proof. No treatment was tested.
Efficacy and Safety of Sodium-Glucose Cotransporter 2 Inhibitors in the Very Elderly with Chronic Kidney Disease: a Retrospective Cohort Study Using Real-World Data
This used real-world records to study SGLT2 blockers, a diabetes drug that also protects kidneys, in people 80 and older with kidney disease. Very old people were left out of the big trials, so this fills a gap. It links starting the drug to survival, kidney and heart outcomes, but as a records study it shows a link, not proof. This early report has not been peer-reviewed yet.
Genetic and environmental risk factors for intracranial aneurysm and subarachnoid haemorrhage among patients with Autosomal Dominant Polycystic Kidney Disease
This studied people with polycystic kidney disease, an inherited disease that fills the kidneys with cysts. It looked at what raises the risk of a brain aneurysm, a weak bulging blood vessel, and its rupture. It found genetic and environmental risk factors that could help decide who to screen. It shows links, not proof, and has not been peer-reviewed yet.
The Urine Ammonium-pH Index is a Measure of Kidney Tubular Function
This tested a simple urine measure, called the ammonium-pH index, that reflects how well the kidney's tiny tubes handle acid. In this study the measure predicted who would lose kidney function faster. It could become an early warning sign. It shows a link, not proof, and has not been peer-reviewed yet.
Long-Term Heatwave Exposure and Kidney Function Decline in Korean Adults: A Nationwide Cohort Study
This large study in South Korea checked whether long spells of very hot weather harm the kidneys. Adults with more heatwave exposure over time had a faster drop in their kidney filtering rate (eGFR). Because it is an observational study, it shows a link, not proof that heat causes the decline. It is a reminder that heat stress can affect the kidneys.
The Dietary Approaches to Stop Hypertension (DASH) diet score and its association with the Risk of Kidney Function Decline and Mortality among Veterans in the Million Veteran Program
A very large study followed 251,921 U.S. veterans and scored how closely they followed the DASH eating plan, which is rich in fruit and vegetables and low in salt. People who followed it more closely tended to keep their kidney function longer and live longer. Because it watches eating habits instead of assigning diets, it shows a link, not proof. This is an early report that other scientists have not checked yet.