Chronic Kidney Disease Market: Five Emerging Therapies Set to Transform Treatment by 2036

Chronic kidney disease (CKD) treatment is evolving as pharmaceutical companies advance innovative therapies targeting disease progression, kidney function preservation, cardiovascular complications, and CKD-associated anemia. The emerging pipeline includes endothelin receptor antagonists, aldosterone synthase inhibitors, precision genetic treatments, and cell-based approaches. These developments could strengthen treatment options beyond established sodium-glucose cotransporter-2 (SGLT2) inhibitors and mineralocorticoid receptor antagonists (MRAs), creating new opportunities across the chronic kidney disease market through 2036.

LAS VEGAS, Sept. 24, 2026 /PRNewswire/ -- Treatment of chronic kidney disease focuses on delaying kidney failure, reducing cardiovascular risks, and managing complications such as anemia and mineral bone disorders. Established therapies, including empagliflozin (JARDIANCE), finerenone (KERENDIA), and dapagliflozin (FARXIGA/FORXIGA), are improving patient management. These treatments are increasingly complemented by emerging therapeutic approaches intended to address additional mechanisms involved in disease progression.

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The pharmaceutical companies involved in the emerging pipeline include AstraZeneca (zibotentan/dapagliflozin), Boehringer Ingelheim (vicadrostat + empagliflozin), Mineralys Therapeutics (lorundrostat), ProKidney (rilparencel), Disc Medicine (DISC-0974), and others.

According to Aparna Thakur, Project Manager of Forecasting & Analytics at DelveInsight, rilparencel and MZE829 represent potential disease-modifying and precision-genetic opportunities, respectively. These approaches could support differentiated positioning in advanced and APOL1-driven CKD, provided clinical evidence continues to demonstrate meaningful benefits. Thakur also highlighted DISC-0974 as a potential contributor to a new anemia-focused treatment segment within the broader CKD market.

Despite progress in treatment, many patients continue to experience declining kidney function, while underdiagnosis remains a major challenge. Earlier screening using urine albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR), alongside timely intervention, could improve disease management and help identify patients who may benefit from emerging therapies.

The chronic kidney disease market across the seven major markets (7MM), comprising the United States, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan, was valued at approximately USD 5 billion in 2025. The market is expected to expand through 2036, supported by rising disease prevalence, improved diagnosis, increasing awareness, and the introduction of innovative treatments targeting kidney function decline and associated complications.

Five Emerging Therapies to Watch in the Chronic Kidney Disease Market

1. AstraZeneca's Zibotentan/Dapagliflozin

Zibotentan/dapagliflozin is an investigational oral combination therapy developed by AstraZeneca for adults with CKD. It combines zibotentan, an endothelin receptor antagonist, with dapagliflozin, an SGLT2 inhibitor. The combination is designed to address complementary mechanisms contributing to kidney damage and disease progression.

Phase IIb ZENITH-CKD findings demonstrated reductions of up to 52.5% in urinary protein markers. Enrollment in the Phase III ZENITH High Proteinuria trial was completed in late 2024, with topline results anticipated in 2027. Further clinical evidence will be important in determining its potential role in patients with significant proteinuria.

2. Boehringer Ingelheim's Vicadrostat Plus Empagliflozin

Vicadrostat (BI 690517) combined with empagliflozin is an investigational treatment approach targeting aldosterone production and glucose-related kidney pathways. Vicadrostat is an aldosterone synthase inhibitor, while empagliflozin belongs to the established SGLT2 inhibitor class.

In a Phase II CKD study conducted in 2023, the combination demonstrated a reduction of up to 39.5% in albuminuria compared with placebo. These findings support further investigation into whether combining these mechanisms can improve outcomes for patients whose disease remains challenging to manage with existing therapies.

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3. ProKidney's Rilparencel

ProKidney is developing rilparencel, an investigational autologous cell therapy intended to preserve kidney function in patients with advanced CKD. The minimally invasive, percutaneous injectable product is prepared using a patient's own kidney cells and is being investigated for its potential to stabilize eGFR decline and delay or prevent dialysis.

Because rilparencel uses autologous cells, immunosuppressive treatment to prevent rejection is not required. Clinical studies have indicated potential benefits in patients with advanced CKD and diabetes, including stabilization of kidney function or a slower rate of eGFR decline. Additional evidence will be necessary to establish its long-term effectiveness and clinical positioning.

4. Mineralys Therapeutics' Lorundrostat

Lorundrostat is an investigational oral aldosterone synthase inhibitor designed to selectively reduce aldosterone production. Since aldosterone-related pathways contribute to hypertension and kidney damage, targeting this mechanism could provide another approach to managing CKD and associated albuminuria.

In June 2025, Mineralys Therapeutics announced positive topline results from the Phase II EXPLORE-CKD trial evaluating lorundrostat in patients with CKD and albuminuria. The company subsequently presented CKD and hypertension data at the American Society of Nephrology's ASN Kidney Week 2025. In January 2026, it provided a corporate update covering recent and anticipated clinical and regulatory milestones. Future development will help clarify its potential contribution to kidney protection and blood pressure management.

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5. Disc Medicine's DISC-0974

DISC-0974 is an investigational anti-hemojuvelin monoclonal antibody designed to suppress hepcidin production and improve iron availability in patients with anemia of inflammation. The candidate was in-licensed from AbbVie and is being evaluated across multiple anemia indications.