New therapeutic strategies under development to halt the progression of renal failure

Introduction: Chronic kidney disease (CKD) is a pathological condition associated with high morbidity and mortality. Accordingly, prevention of CKD onset and progression is mandatory. As pharmacological agents already used in clinical practice are not yet able to halt the progression of renal damage, new therapeutic strategies are being explored. Areas covered: The authors carried out a systematic review on completed and ongoing Phase I and II clinical trials with an aim to evaluate the safety and efficacy of novel therapeutic approaches to CKD. The data in this manuscript was retrieved from the currently available scientific literature as well as from the ClinicalTrials.gov website. Expert opinion: Several drugs are currently under investigation due to their supposed antiproteinuric action, such as selective endothelin-A receptor antagonists and vitamin D analogues. Other drugs could be used in CKD because of their antifibrotic, anti-inflammatory and antioxidative properties or due to the hypothetical ability to repair damaged podocytes. A fascinating therapeutic approach involves the use of progenitor/stem cells. There is still some way to go in the use of stem cells in clinical practice but remarkable progress has been made. This is especially true in terms of the understanding of their biology and behaviour, as well as in the procedures required to mobilize and activate endogenous stem cells in damaged kidneys or simply introducing them.