Top 5 Most-Read Chronic Kidney Disease Content of 2025

Chronic kidney disease (CKD) continues to be a major health challenge, and 2025 brought several notable advances in treatment, care models, and guideline updates. From the FDA’s accelerated approval of atrasentan for IgA nephropathy, a rare kidney disorder with high risk of progression, to evidence showing that value-based and integrated care programs can slow CKD progression and reduce hospitalizations, the year highlighted strategies that improve patient outcomes. Updated KDIGO guidelines further emphasized individualized risk assessment, early detection, and evidence-based interventions, underscoring a growing focus on tailored, multidisciplinary approaches to preserve kidney function and reduce cardiovascular risk.

Here are the top 5 most-read CKD stories of 2025.

5. New Hope for IgA Nephropathy With Atrasentan Approval: Richard Lafayette, MD, FACP

On April 2, the FDA granted accelerated approval to atrasentan (Vanrafia; Novartis) for reducing proteinuria in patients with primary IgA nephropathy, marking it as the second “first and only” therapy for a rare kidney disorder within a month. Richard Lafayette, MD, FACP, professor of medicine, nephrology, and director, Glomerular Disease Center, Stanford University Medical Center, discussed the approval, which was based on a prespecified interim analysis of the phase 3 ALIGN study, which showed that atrasentan reduced proteinuria by 38% compared with minimal reductions in placebo, suggesting it may slow progressive kidney damage. The drug was well tolerated, with no significant fluid retention, heart failure, or liver toxicity, and demonstrated consistent effects across diverse patient populations. Lafayette emphasized that IgA nephropathy carries high long-term risk of kidney failure even in patients initially considered low risk, making early intervention with effective, safe therapies like atrasentan a potentially meaningful advance in care.

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4. FDA Approves Atrasentan for Proteinuria Reduction in Primary IgA Nephropathy

The FDA granted accelerated approval to atrasentan for reducing proteinuria in patients with primary IgA nephropathy, providing a new oral, once-daily treatment option alongside standard supportive care. Primary IgA nephropathy, a rare kidney disease affecting about 13 per million people in the US, can lead to kidney failure in up to half of patients within 10 to 20 years, making proteinuria reduction critical. Atrasentan, a selective endothelin A receptor antagonist, inhibits pathways by which endothelin contributes to kidney damage. In the phase 3 ALIGN study, patients taking atrasentan experienced a 36% reduction in proteinuria compared with placebo over 36 weeks, with consistent results across subgroups, including those on sodium-glucose cotransporter 2 (SGLT2) inhibitors. Adverse events were generally mild, affecting about 2% of participants, and the therapy does not require a Risk Evaluation and Mitigation Strategies program. Experts hailed the approval as a meaningful advancement for preserving kidney function in patients with IgA nephropathy.

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3. Value-Based Care Interventions and Management of CKD Progression

A recent retrospective cohort study of 623 patients with stage 3b or 4 CKD found that enrollment in a value-based care (VBC) program was associated with significantly slower disease progression, as measured by estimated glomerular filtration rate (eGFR) decline. By comparing patient-specific eGFR trajectories before and after enrollment, researchers observed a 77.2% reduction in the median rate of decline for stage 3b and a 65.2% reduction for stage 4 CKD, resulting in higher-than-expected kidney function over time. The VBC program used a high-touch, multidisciplinary care model with proactive monitoring, individualized treatment plans, and patient engagement to manage comorbidities and support kidney health. These findings suggest that VBC interventions can meaningfully slow CKD progression, particularly in advanced stages, potentially delaying the need for dialysis or renal replacement therapy and improving patient outcomes.

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2. New Guideline Updates to Slow CKD Progression and Reduce Cardiovascular Risk

The 2024 Kidney Disease: Improving Global Outcomes guideline update for CKD emphasizes improved risk assessment, individualized care, and evidence-based interventions to slow disease progression and reduce cardiovascular risk. Key updates include the preferential use of cystatin C for more accurate glomerular filtration rate measurement and the adoption of point-of-care creatinine and urine albumin testing to enhance early detection in underserved areas. The guideline expands the use of SGLT2 inhibitors beyond diabetes, showing substantial reductions in kidney disease progression, acute kidney injury, and heart failure hospitalization across diverse patient populations. It also recommends a targeted approach to hyperuricemia, treating only symptomatic patients, and reinforces statin therapy for cardiovascular risk reduction in adults with CKD, particularly those over 50 or with additional risk factors. Overall, the guideline integrates these strategies to optimize kidney and cardiovascular outcomes through tailored, evidence-based care.

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1. Integrated CKD Care Model Cuts ED Visits by 30%, Boosts Specialized Treatment

A Mayo Clinic study published in Kidney360 found that an interdisciplinary care model for CKD significantly reduced acute care use, with hospital admissions down 26% and emergency department visits down 30% among 534 patients. The clinic combined a CKD registry with coordinated specialist care, emphasizing evidence-based pathways, patient education, and shared decision-making. Most patients, particularly in early-stage CKD, remained stable or progressed modestly, while advanced-stage patients benefited from multidisciplinary support. Nephrology consultations increased by 46% and primary care visits decreased by 22%, reflecting improved access to specialized care. Physical inactivity and unemployment or disability were linked to higher odds of disease progression. Despite limitations including its retrospective, single-center design and predominantly White population, the study suggests integrated, team-based CKD care can improve outcomes, reduce acute care use, and address modifiable lifestyle and socioeconomic factors.

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