Table 1.

Emerging therapeutic approaches for cardiovascular complications in CKD.

Medication	Clinical Trial	Population (Number of Patients)	Intervention	Comparison	Outcome	Notable Effects/ Considerations	Ref
Atrasentan	SONAR	Diabetic nephropathy, CKD patients (2648)	Endothelin receptor antagonist (atrasentan)	Placebo or standard therapy	Slows CKD progression and reduces vasoconstriction, fibrosis, inflammation, and cardiovascular risk	Particularly beneficial in diabetic nephropathy	[179]
Finerenone	FIDELIO-DKD	Diabetic kidney disease patients with CKD (5734)	Non-steroidal mineralocorticoid receptor antagonist	Placebo or steroidal MRAs	Reduced CKD progression and cardiovascular events	Lower risk of hyperkalemia compared to steroidal MRAs	[180]
Finerenone	FIGARO-DKD	Diabetic kidney disease patients with earlier-stage CKD (7352)	Non-steroidal mineralocorticoid receptor antagonist	Placebo or steroidal MRAs	Reduced cardiovascular events and slower CKD progression	Beneficial even in patients with early CKD	[181]
Empagliflozin	EMPA-KIDNEY	CKD patients, particularly with type 2 diabetes (6609)	SGLT2 inhibitor	Placebo or standard therapy	Decreases CKD progression and cardiovascular mortality	Provides cardiovascular and renal protection independent of glycemic control	[183]
Semaglutide	FLOW	CKD patients with type 2 diabetes (3000)	GLP-1 receptor agonist	Placebo or standard therapy	Slowed CKD progression	Potential to slow kidney disease progression alongside glucose control	[184]
Semaglutide	SELECT	Obese patients with cardiovascular disease (17,604)	GLP-1 receptor agonist	Placebo or standard therapy	Reduced risk of MACE by 20% in patients with obesity and cardiovascular disease	Cardiovascular benefits independent of glucose control	[185]
CRISPR Gene Therapy	Ongoing research	Patients with genetic causes of CKD (ongoing)	CRISPR-based gene editing	Standard treatment or no gene therapy	Potential for long-lasting correction of genetic mutations; still experimental	Promising but undergoing ongoing research	[177]
Canakinumab	CANTOS	CKD patients with increased cardiovascular risk (10,061)	IL-1β inhibitor	Placebo or standard therapy	Reduces cardiovascular events by targeting inflammatory pathways	Anti-inflammatory effects	[191]
Ziltivekimab	RESCUE	CKD patients with high CRP levels (623)	IL-6 inhibitor	Placebo	Reduces inflammation and thrombosis	Shows promise in managing inflammation-related CKD complications	[192]
Mesenchymal Stem Cells (MSCs)	Early-stage trials	CKD patients, particularly with diabetic or hypertensive nephropathy (ongoing)	Stem cell therapy	Standard therapy or no MSC therapy	Repairs damaged kidney tissue and reduces fibrosis and inflammation; early-stage trials	Promising for nephroprotection and delivery of Klotho	[208,209]