How To Manage And Slow Down Kidney Disease, 2026 Breakthroughs

Approximately 37 million American adults have chronic kidney disease. Ongoing research continues to uncover ways to help slow down this disease with new treatment choices. 

As of 2026, several newly approved drugs are being recognized for managing chronic kidney disease (CKD) and its subtypes, IgA nephropathy, polycystic kidney disease, and diabetic kidney disease. These medications often center around SGLT2 inhibitors, GLP-1 agonists, ACE inhibitors, and ARBs. These drugs slow the progression of the disease, reduce protein in urine, and lower cardiovascular risk. 

Here, we take a closer look at each drug category:

SGLT2 Inhibitors

Sodium-Glucose-Cotransporter 2 inhibitors are a class of oral medications that are used primarily to manage type 2 diabetes, chronic kidney disease, and heart failure.  They work by blocking the reabsorption of glucose in the kidneys. This leads to increased glucose output in the urine, which results in lower blood sugar levels. SGLT2 inhibitors can slow the progression of kidney damage and reduce cardiovascular events.

These medications are not a cure but can help manage kidney and heart health. “The benefits are even stronger for people who also have albuminuria. SGLT2 inhibitors can also help people with other causes of kidney disease, including glomerular diseases like IgA nephropathy.”

SGLT2 inhibitors help patients with kidney disease by lowering blood sugar and blood pressure, as well as directly protecting the kidneys from damage. They also reduce inflammation and fibrosis, which improves kidney health.

Medications available:

• Farxiga (Dapagliflozin) - This treatment can slow the progression of kidney disease and lower the risk of serious kidney problems by 39% even without diabetes. This prevents the kidneys from reabsorbing sugar back into the body. It also reduces pressure in the kidneys and heart. Common side effects are yeast infections, urinary tract infections, a runny nose, and dehydration/dizziness.
• Jardiance (Empagliflozin) - This treatment can slow the progression of kidney disease and lower the risk of serious kidney problems by 29%. This helps the kidneys remove excess sugar and salt from the body through urine. There is no generic version available, and this medication can be used by all kidney patients (those who have diabetes and those who do not). Common side effects are increased urination, upper respiratory infections, joint pain, and nausea.
• Invokana (Canagliflozin) - This treatment can slow the progression of kidney disease and lower the risk of serious kidney problems by 30%. By blocking the SGLT2 in the kidneys, it lowers the blood sugar and reduces the strain on the kidneys and heart. It is not recommended for patients with type 1 diabetes and severe kidney problems.  Common side effects are increased urination and thirst, constipation, and nausea.
• Steglatro (Ertugliflozin) - This treatment can slow the progression of kidney disease and lower the risk of serious kidney problems by 34%. Excess sugar is removed from the body in the urine. It is not for patients with type 1 diabetes and is not recommended for those on dialysis. Clinical trials show Steglatro to have little effect on heart disease. Common side effects are infections, increased urination, headache, and thirst.
• Brenzavvy (Bexagliflozin) - This treatment has had no studies specifically studying this drug on kidney disease. For patients with type 2 diabetes. It works through the kidneys to reduce excess sugar through urine. Common side effects are infections and increased urination.

GLP-1 Agonists

These are powerful medications that are typically used for diabetes and weight loss. They also protect the kidneys by slowing down disease progression, reducing inflammation, lowering blood pressure, decreasing protein in urine, and improving heart health in patients with type 2 diabetes and chronic kidney disease (CKD). They are recommended for CKD patients because they protect the kidneys and the heart.

Clinical trials have shown that GLP-1 agonists can significantly slow the progression of kidney disease and lower the risk of kidney failure. They can restore normal blood flow within the kidneys, which helps protect against damage.

Medications available:

• Byetta or Bydureon (Exenatide) - No evidence suggesting it may slow progression of kidney disease and reduce kidney events. May modestly reduce albuminuria (an early sign of kidney damage). Exenatide carries specific warnings regarding its use in patients with existing kidney issues.
• Trulicity (Dulaglutide) - This treatment can slow the progression of kidney disease and lower the risk of serious kidney problems by 13% - 15%. It can lower albuminuria (protein in urine) and existing protein leakage. It works as a GLP-1 agonist, improving blood sugar.
• Ozempic or Wegovy (Semaglutide) - This treatment can slow the progression of kidney disease and lower the risk of serious kidney problems by 24%.
• Mounjaro or Zepbound (Tirzepatide) - This treatment can slow the progression of kidney disease and lower the risk of serious kidney problems by 46% - 48%, as well as reduce protein in the urine. In trials, Mounjaro lowered the risk of major kidney issues such as eGFR decline, renal death, and progression to end-stage kidney disease.
• Victoza or Saxenda (Liraglutide) - This treatment can slow the progression of kidney disease and lower the risk of serious kidney problems by about  22%. It helps improve blood sugar control and heart health. But its gastrointestinal side effects (nausea, vomiting, diarrhea) can lead to dehydration, which can worsen existing kidney disease. Close monitoring is recommended.

Mineralocorticoid Receptor Antagonists (MRAs)

These are a class of medications that block the effects of the hormone, aldosterone. This hormone helps regulate blood pressure and electrolytes. These receptors are found in tissues like the brain, kidneys, heart, and blood vessels. They cause the kidneys to excrete salt and water. This helps to lower blood pressure.

MRAs primarily treat hypertension, heart failure, and kidney disease. Precautions should be taken for patients with kidney disease, liver disease, and those with high potassium levels.

MRAs can help with kidney disease by reducing inflammation and fibrosis, which helps protect the kidneys and slow down kidney disease. They also decrease the risk of cardiovascular events, which are a common complication.

Medications available:

• Aldactone or CaroSpir (Spironolactone) - This treatment showed temporary improvements in kidney disease progression. It blocks the hormone aldosterone, causing the kidneys to excrete excess sodium and water but retain potassium, which helps lower blood pressure, reduce fluid buildup (edema) in conditions like heart failure or liver/kidney disease, and treat conditions with too much aldosterone (hyperaldosteronism).
• Inspra (Eplerenone) - This treatment helps slow the long-term decline of the estimated glomerular filtration rate (eGFR). Blocks the hormone aldosterone, acting as a mineralocorticoid receptor antagonist to help the body excrete excess salt and water, thereby lowering blood pressure and reducing fluid buildup, which protects the heart and kidneys. Because the kidneys are responsible for clearing potassium, using an MRA like Inspra requires careful medical supervision.
• Kerendia (Finerenone) - This treatment can slow the progression of kidney disease and lower the risk of serious kidney problems by about  40%.This is an nsMRAs (Non-Steroidal Mineralocorticoid Receptor Antagonists), which is used to reduce the risk of kidney decline and end-stage kidney disease.

Specific Targeted Therapy

Medications available or soon to be available:

• Voyxact (Sibeprenlimab) for IgA nephropathy - Recently FDA approved. This drug showed a 50% reduction in proteinuria. It blocks the protein APRIL (A PRoliferation-Inducing Ligand), which is crucial in IgA Nephropathy (IgAN). By neutralizing APRIL, sibeprenlimab reduces the overproduction of this abnormal IgA, leading to less inflammation in the gut and kidneys, fewer damaging immune complexes in the kidneys, and a significant reduction in proteinuria, slowing kidney damage and progression to kidney failure.
• ABBV-CLS-628 for polycystic kidney disease - Investigational therapy that was recently fast-tracked by the FDA to accelerate its development. It's an anti-PAPP-A monoclonal antibody being developed for Autosomal Dominant Polycystic Kidney Disease (ADPKD). It works by blocking Pregnancy-Associated Plasma Protein-A (PAPP-A) to slow kidney cyst growth. 

Overview

Although chronic kidney disease is generally progressive and irreversible, there are steps patients can take to slow progression. These options enable patients to live longer without complications.

Patients with chronic kidney disease need regular blood tests to monitor kidney function. Be cautious with over-the-counter medications (Advil, Aleve) and prescription drugs that can worsen kidney damage. Any medication decisions should be made with your doctor.

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