What is the new medicine to improve kidney function?

October 14, 2025 •

3 min read

According to the National Kidney Foundation, recent advancements have expanded treatment options for chronic kidney disease (CKD), providing new medications that offer significant benefits beyond blood sugar control. This progress raises the critical question: What is the new medicine to improve kidney function? The answer involves several classes of drugs and novel therapies that aim to slow disease progression and protect vital organ function.

Quick Summary

Several new medications are improving kidney function by slowing disease progression in chronic kidney disease, notably SGLT2 inhibitors and non-steroidal mineralocorticoid receptor antagonists. These advancements, including agents like finerenone and semaglutide, offer significant cardiorenal protection for various patient populations, with or without diabetes.

Key Points

SGLT2 inhibitors: Oral medications like Farxiga (dapagliflozin) and Jardiance (empagliflozin) are now standard of care for slowing CKD progression by reducing pressure within the kidney's filters, even for patients without diabetes.
Finerenone (Kerendia): This non-steroidal MRA treats CKD in adults with type 2 diabetes by blocking a hormone receptor, which reduces kidney inflammation and fibrosis. It is typically added to other standard therapies.
GLP-1 agonists: In January 2025, semaglutide (Ozempic) was approved for diabetic CKD to reduce kidney disease progression and cardiovascular risk, while also showing promise in non-diabetic patients.
Targeted therapies: Specific conditions like IgA nephropathy and primary hyperoxaluria have new, dedicated treatments like atrasentan, sparsentan, and nedosiran, respectively.
Combination treatment: New studies support the safe and effective combination of finerenone and SGLT2 inhibitors for enhanced kidney protection in diabetic CKD patients.
Future innovations: Ongoing research includes new drugs like baxdrostat for resistant hypertension and kidney disease, alongside advanced therapies like pig kidney xenotransplantation.

The Rise of SGLT2 Inhibitors

Sodium-glucose co-transporter-2 (SGLT2) inhibitors, including dapagliflozin (Farxiga) and empagliflozin (Jardiance), are oral medications initially for type 2 diabetes that have shown significant kidney- and heart-protective effects, leading to expanded FDA approvals for chronic kidney disease (CKD), even in those without diabetes. They work by blocking glucose and sodium reabsorption in the kidneys, which reduces pressure in the filtering units (glomeruli) and slows kidney function decline. An initial eGFR drop is expected and reflects this pressure reduction, not worsening function.

Finerenone: A New Generation of Kidney Protection

Finerenone (Kerendia) is a non-steroidal mineralocorticoid receptor antagonist (MRA) approved in 2021 for adults with CKD and type 2 diabetes. It blocks the mineralocorticoid receptor, which helps reduce inflammation and scarring (fibrosis) in the kidneys and heart. Finerenone's benefits are in addition to standard care like ACE inhibitors or ARBs and have been shown in trials to reduce the risk of CKD worsening and cardiovascular events. Monitoring for hyperkalemia is necessary.

GLP-1 Receptor Agonists Join the Fight

Glucagon-like peptide-1 (GLP-1) receptor agonists, known for treating type 2 diabetes and obesity, also offer cardiorenal protection. In January 2025, semaglutide (Ozempic) was approved by the FDA to reduce the risk of kidney disease progression and cardiovascular death in adults with CKD and type 2 diabetes. These medications help control blood sugar and weight, reducing stress on the kidneys. The FLOW trial demonstrated semaglutide's benefits in slowing kidney disease and reducing cardiovascular events, with research also showing promise in non-diabetic CKD with proteinuria.

Targeted Treatments for Specific Kidney Diseases

Recent advancements include therapies for specific kidney conditions:

IgA Nephropathy (IgAN): Atrasentan (Vanrafia), an endothelin A receptor antagonist, received accelerated approval in April 2025 for reducing proteinuria. Sparsentan, a dual endothelin and angiotensin II receptor antagonist, was fully approved in September 2024 for proteinuria reduction in IgAN.
Primary Hyperoxaluria Type 1 (PH1): Nedosiran (Rivfloza), approved in late 2023, is a monthly injection to lower urinary oxalate levels in this rare genetic disease.
Lupus Nephritis: Updates in 2025 include new FDA activity around medications like obinutuzumab and belimumab.

Comparing New Medication Classes for Kidney Function


Feature	SGLT2 Inhibitors	Non-steroidal MRAs	GLP-1 Receptor Agonists
Examples	dapagliflozin (Farxiga), empagliflozin (Jardiance)	finerenone (Kerendia)	semaglutide (Ozempic), dulaglutide (Trulicity)
Primary Mechanism	Blocks glucose/sodium reabsorption in kidneys, lowering glomerular pressure.	Blocks mineralocorticoid receptor, reducing inflammation and fibrosis.	Increases insulin, slows digestion, helps with weight loss.
Target Population (CKD)	Diabetic & non-diabetic CKD, with or without albuminuria.	Diabetic CKD with albuminuria.	Diabetic CKD, potentially non-diabetic.
Key Benefits	Slows CKD progression, reduces heart failure risk.	Slows CKD progression, reduces cardiovasc. events.	Slows CKD progression, reduces cardiovasc. events, aids weight loss.
Key Side Effects	Genital fungal infections, increased urination.	Risk of hyperkalemia (high potassium).	Nausea, vomiting, stomach issues.

The Future of Kidney Therapy: From Research to Reality

Promising research avenues include Baxdrostat for resistant hypertension and kidney disease, xenotransplantation using genetically edited pig kidneys, and cellular therapies like rilparencel for diabetic CKD.

Conclusion

The treatment of kidney disease has significantly advanced with new medication classes like SGLT2 inhibitors, finerenone, and GLP-1 agonists offering improved cardiorenal protection. Targeted therapies are also emerging for specific conditions. These developments, along with ongoing research, provide more options to delay kidney failure and enhance quality of life. Patients should consult their nephrologist to determine the best individualized treatment plan, which may include combination therapy.

Frequently Asked Questions

SGLT2 inhibitors are a class of oral medications, including Farxiga and Jardiance, that were originally used for type 2 diabetes. They improve kidney function by blocking the reabsorption of glucose and sodium in the kidneys, which lowers blood pressure and reduces stress on the kidneys' filters, thereby slowing the progression of chronic kidney disease.

While SGLT2 inhibitors reduce pressure on the kidneys' filters, finerenone (Kerendia) is a non-steroidal mineralocorticoid receptor antagonist. It works by blocking a hormone receptor to reduce the inflammation and scarring (fibrosis) that can damage the kidneys and heart.

Yes, as of January 2025, the FDA approved semaglutide (Ozempic) for use in people with type 2 diabetes and chronic kidney disease. While previously known for diabetes and weight loss, it is now officially indicated to reduce the risk of kidney disease worsening and cardiovascular events in this population.

Yes, for example, SGLT2 inhibitors like dapagliflozin (Farxiga) and empagliflozin (Jardiance) have been approved for use in patients with chronic kidney disease regardless of their diabetes status. However, other medications like finerenone are currently approved specifically for diabetic CKD.

Yes, recent FDA approvals include atrasentan and sparsentan for IgA nephropathy and nedosiran for primary hyperoxaluria type 1. These targeted therapies address the specific mechanisms driving these diseases.

SGLT2 inhibitors can cause increased urination and a higher risk of genital fungal infections. Finerenone carries a risk of hyperkalemia (high potassium levels). GLP-1 agonists often cause gastrointestinal issues like nausea, vomiting, and diarrhea. Your doctor will monitor for and discuss specific side effects.

Before starting any new treatment, discuss your specific type of kidney disease, overall health, and other medications you are taking. Your doctor will determine which therapy is most appropriate for you, considering potential benefits and risks. Don't stop or start new medications without consulting your healthcare provider.