A patient dealing with kidney health issues who could be an eligible candidate for a chronic kidney disease clinical trial

Chronic Kidney Disease Clinical Trials

Chronic kidney disease (CKD) is a progressive condition that affects an estimated 37 million adults in the United States. Current treatments help protect kidney function and slow disease progression, but many CKD patients still advance toward kidney failure, or end-stage renal disease, particularly when the disease goes undiagnosed in its early stages.

CKD clinical trials are helping to expand treatment options and improve outcomes for patients living with this disease.

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Current treatment for chronic kidney disease (CKD) patients

CKD is defined as a reduction in kidney function or structure that lasts more than three months, most often measured through estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR). The disease progresses through five stages, and treatment goals shift as kidney function declines: protect remaining function, manage complications, and delay the need for dialysis or kidney transplantation.

RAS inhibitors, including ACE inhibitors and ARBs, have been the foundation of CKD treatment for years. These medications lower blood pressure and reduce protein in the urine, which helps slow kidney damage over time.

SGLT2 inhibitors have become a newer standard of care. Originally developed for type 2 diabetes, this drug class now shows kidney-protective benefits in patients with and without diabetes. Current guidance supports using them alongside RAS inhibitors in appropriate patients.

Nonsteroidal mineralocorticoid receptor antagonists (MRAs), such as finerenone, are also gaining ground. They target a different pathway tied to kidney inflammation and scarring, and physicians increasingly add them for patients with persistent protein in their urine despite other treatments.

Even with these options, many CKD patients lose kidney function, especially those with rare subtypes like IgA nephropathy or polycystic kidney disease, or those who reach later stages before treatment starts. That gap is one of the reasons why CKD trials are so important.

Focus areas in modern CKD clinical trials

Combination Therapies
Therapies for Rare CKD Subtypes
Decentralized and Hybrid Trial Models

Combination Therapies

Researchers are studying how RAS inhibitors, SGLT2 inhibitors, MRAs, and GLP-1 receptor agonists work together versus alone. Trials are evaluating whether layering these therapies produces a bigger drop in protein loss and a slower decline in kidney function than any one treatment can achieve. This combination approach also looks at possible risks to cardiovascular health, since CKD and heart disease often progress together.

Therapies for Rare CKD Subtypes

Conditions like IgA nephropathy and polycystic kidney disease affect a smaller patient population but carry their own distinct disease pathways. Clinical trials in this space are testing therapies aimed at the specific mechanisms driving these subtypes, giving patients options beyond general CKD management.

Decentralized and Hybrid Trial Models

CKD trials often run for months or years, which places a real burden on patients who need frequent lab draws and clinic visits. Hybrid and decentralized trial designs, supported by remote monitoring and local lab partnerships, help reduce that burden while keeping data collection consistent and reliable.

A health care professional discusses treatment protocol based on a diagnosis with a patient

RDI's experience in CKD clinical studies

With over 30 years of experience, Remington-Davis (RDI) brings extensive nephrology expertise to CKD clinical research. Our resident nephrologist and principal investigator, Kevin Schroeder, MD, leads a group nephrology practice with 19 providers, giving us a strong base of eligible patients for CKD studies. We've supported a number of nephrology studies in the past several years, including one hypertension-in-CKD study where we identified and consented 73 subjects in seven months, making RDI one of the most productive sites in the country for that trial.

Because CKD disproportionately affects minority populations, inclusive recruitment matters. Our patient outreach maintains a nearly 36% diversity rate, aligning with FDA guidance on inclusive enrollment in study populations.

Each study benefits from same-day data entry into our EDC system and eSource-supported remote monitoring, giving sponsors real-time visibility into site performance. We're experienced in running hybrid and decentralized trials, which reduces the burden long-running CKD studies place on patients.

Backed by a patient-centric approach, we offer flexible scheduling, transportation services, and a 7,500-square-foot facility with private rooms for extended visits or serial blood draws, along with Wi-Fi, snacks, and other at-home comforts and amenities. These details help us maintain a 96% patient retention rate.

At RDI, we're committed to advancing kidney disease research while fostering a supportive, patient-centered experience, because better trials mean better treatments for everyone. Be a part of our next medical breakthrough

Be a part of our next chronic kidney disease medical breakthrough.

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Who can participate in a CKD research study?

Patients across the different stages of CKD may qualify for clinical trials, based on their eGFR, UACR, current treatment plan, and any underlying causes like diabetes or hypertension. Some studies focus on specific populations, such as patients with hypertension-related kidney disease or rare subtypes, while others look at broader CKD populations, including groups disproportionately affected by the disease.

Healthy volunteers are also needed to help establish the safety profile of new investigational treatments before they move to larger patient populations.

Frequently asked questions about chronic kidney disease clinical trials

What are the five stages of CKD, and how do they inform which trial someone qualifies for?

CKD is staged 1 through 5 based on eGFR, with stage 1 reflecting near-normal kidney function and stage 5 marking kidney failure, where dialysis or transplant becomes necessary. Early-stage trials tend to focus on slowing progression and catching the disease before much damage occurs. Mid-stage trials often test combination therapies to prevent further decline. Late-stage trials look at delaying dialysis, easing complications, or supporting patients already on dialysis. Screening matches a candidate's current stage to the studies built for it.

Can I join a CKD clinical trial if I'm already on dialysis?

It depends on the study's focus and eligibility criteria. Some CKD trials focus on earlier stages of the disease to slow progression before dialysis becomes necessary, while others are designed for patients already on dialysis or approaching end-stage kidney disease. Our team reviews each participant's full medical history during screening to determine which studies fit.

Can I participate in a CKD trial if I've had a kidney transplant?

This also depends on the study. Some CKD trials exclude transplant recipients because immunosuppressants can affect results, while others focus specifically on kidney function or complications in transplant patients. Our study team assesses transplant history and any subsequent follow-up care during screening to match people to the right trial.

How do researchers measure whether a CKD treatment works?

Researchers typically track eGFR, a measure of how well the kidneys filter waste, along with UACR, which shows how much protein is leaking into the urine. They also monitor blood pressure, time to dialysis or transplant, cardiovascular events, and patient-reported outcomes covering how symptoms affect daily life and quality of life. Tracking these measures shows if an investigational treatment is making a meaningful difference.

Do I gain access to health education or lifestyle support during the trial?

Many CKD clinical trials build health education into the patient experience. Diet contributes to managing kidney disease, particularly sodium, potassium, and protein intake, and study teams often cover nutrition guidance alongside the investigational treatment. Participants may also receive support around blood pressure monitoring, medication management, and staying on top of routine lab work between visits.

What happens after I'm found eligible for a type 2 diabetes trial?

Once you meet the eligibility criteria, our team walks you through informed consent, answers any questions about the study design, and schedules your first visit. From there, you'll follow a structured visit schedule where our clinical team monitors your safety and progress throughout participation.

An example of advanced CKD causing body pain in an individual