Overview
Unverified · drafted by AI from the sources cited below
Definition
Chronic kidney disease involves conditions in which the kidneys perform below the normal level for more than three months.1 Chronic kidney insufficiency is classified by five stages according to the decline in glomerular filtration rate and the degree of kidney damage, as measured by the level of proteinuria.1 The condition is generally characterized by low glomerular filtration rate or albuminuria.2
Diagnosis and risk stratification
The most severe form of the condition is end-stage renal disease.1 Estimated glomerular filtration rate is widely utilized as a marker of risk profile in cardiovascular diseases, including heart failure.2 Acute kidney disease, defined as acute kidney injury persisting for 7 to 90 days, represents a window for interventions and is associated with progression to de novo chronic kidney disease.3
Treatment
Compared with placebo, sodium-glucose cotransporter-2 inhibitors reduced the risk of first heart failure hospitalization or cardiovascular death by 23% in chronic kidney disease based on an analysis of 90,413 patients.1 Finerenone, a selective nonsteroidal mineralocorticoid receptor antagonist, has favorable effects on cardiorenal outcomes in patients with predominantly stage 3 or 4 chronic kidney disease with severely elevated albuminuria and type 2 diabetes.2 In a small subgroup analysis of 5 patients, teriparatide improved bone mineral density at the lumbar spine and femoral neck in stage 4 chronic kidney disease.3
Open questions
The use of finerenone in patients with type 2 diabetes and a wider range of chronic kidney disease, such as stage 1 or 2, is unclear.1 Additionally, the safety and efficacy of IL-6 inhibition among individuals at high atherosclerotic risk but without a systemic inflammatory disorder is unknown.2
Guideline updates
Society guidelines, scientific statements and expert consensus on Chronic kidney disease from the last three months.
Guideline updateAug 29, 2026
2026 ESC Guidelines for the management of cardiovascular disease and chronic kidney disease
This is the first ESC Guideline dedicated to the management of cardiovascular disease (CVD) and chronic kidney disease (CKD), centred around the “STAMP on CKD” framework.
European Society of Cardiology
FDA actions
FDA approvals, label changes, device decisions and recalls on Chronic kidney disease from the last three months.
FDA generic approvalSep 22, 2026
FDA generic approval: Empagliflozin
The FDA has noted an original approval for a tablet formulation. However, specific details regarding the drug name and indication were not provided in the announcement.
EMPAGLIFLOZINempagliflozin
FDA
FDA approvalSep 17, 2026
FDA approval: Empagliflozin
The FDA has issued a drug approval for an original submission available in a solution formulation. Further details regarding the drug's name and indication were not specified in the release.
EMPAGLIFLOZINempagliflozin
FDA
New research on Chronic kidney disease
Supplementation with <i>Enterococcus lactis</i> (SF68) and its association with biochemical parameters and inflammatory biomarkers related to renal impairment in dogs with chronic kidney disease.
López R — Dec 2026
Risk factors associated with rapid progression of chronic kidney disease. A retrospective cohort study.
Chogtu B — Oct 2026
Landmark trials
Primary results of 5 trials behind the evidence on chronic kidney disease, as each trial’s own publication reports them.
Left of the line at 1 favours the intervention; square size tracks trial size.Favours the interventionNo significant differenceFavours the comparator
0.512
semaglutide vs placebo · 3,533 patients · N Engl J Med 2024
In patients with type 2 diabetes and chronic kidney disease
Primary outcome: major kidney disease events, a composite of the onset of kidney failure (dialysis, transplantation, or an eGFR of <15 ml per minute per 1.73 m2), at least a 50% reduction in the eGFR from baseline, or death from kidney-related or cardiovascular causes
Key papers
Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes
New England Journal of Medicine
1,805 citations · 2021 · among the most cited on Chronic kidney disease
IL-6 inhibition with ziltivekimab in patients at high atherosclerotic risk (RESCUE): a double-blind, randomised, placebo-controlled, phase 2 trial
The Lancet — Ridker P
744 citations · 2021 · among the most cited on Chronic kidney disease
Kidney Function and Outcomes in Patients Hospitalized With Heart Failure
Journal of the American College of Cardiology — Patel R
204 citations · 2021 · among the most cited on Chronic kidney disease
How this page is built
A clinical question appears here only when its condition matches this topic, an outcome and a comparator were extracted from the studies, at least two studies and a patient count are on file, and the certainty is low or higher.
Supports benefit, no benefit shown, and mixed describe the direction of the measured effect. No benefit shown means the evidence does not support a benefit. It is not a finding of harm. Too little evidence means the question did not clear that bar.
Study count, RCT count, and patient count are separate. The patient total adds only studies that are linked into a study family and whose sample size is not flagged as implausible. A reversal is listed only when at least one randomized trial sits on each side of the change.
The overview is drafted from the guideline recommendations, trials, papers, and questions on this page, and every sentence has to cite one of them. It stays unverified until an NPI-verified clinician or a Synapse admin approves it. Approving records that person's name.
