Pharmacotherapeutic Advances in Protecting Renal Function: Emerging Drug Strategies for Kidney Disease Management

Abstract

Chronic kidney disease (CKD) is a progressive condition associated with substantial morbidity, mortality, and healthcare burden worldwide. Although the traditional renoprotective treatment methods, including renin-angiotensin-aldosterone system blockage and glycemic regulation, have been used long ago, a substantial number of patients still report progressive deterioration of kidney function. The pharmacotherapy over the last few years has transformed how kidney disease should be treated with new drug classes with novel approaches towards alternative and understudied pathogenic pathways. This is a holistic narrative literature review that combines the existing information on proven and novel pharmacotherapeutic methods to guard against renal dysfunction. Such innovative agents as sodium-glucose cotransporter-2 inhibitors, non-steroidal mineralocortin receptor antagonists, endothelin receptor antagonists, anti-inflammatory and anti-fibrotic agents have become available, and each of them targets hemodynamic, metabolic, inflammatory, and fibrotic pathways of renal injury. Also, the recent developments of precision pharmacotherapy, such as targeted biologics, RNA-based therapeutic options, and pharmacogenomics, also point to the individualised approach to treatment. In the review, clinical issues concerning the safety of drugs, translation gaps, and their real-world practice are also mentioned. Altogether, the available pharmacotherapeutic approaches can be of rich potential to reduce the CKD progression rate and enhance renal outcomes in the long term, which could contribute to a paradigm shift in favour of multi-pathway and individual renoprotective therapy.