UCSF Is Testing 16 New Kidney Disease Treatments Right Now—Here's What They Could Mean for You

UCSF is currently running 16 clinical trials for chronic kidney disease (CKD), with 7 actively enrolling eligible patients. These studies are testing new medications designed to lower protein in the urine, slow kidney function decline, improve transplant success rates, and expand access to care for low-income patients through telehealth programs.

What New Kidney Disease Treatments Are Being Tested?

The trials at UCSF span several promising approaches to managing kidney disease. Researchers are evaluating medications that work through different mechanisms—some targeting antibody responses that prevent transplantation, others focusing on reducing the protein loss that damages kidneys over time. The diversity of these studies reflects the reality that kidney disease isn't one-size-fits-all; different patients need different treatment strategies.

Several specific medications are in the spotlight. One trial is testing vonsetamig in adults aged 18 to 70 who need kidney transplants but are highly sensitized to human leukocyte antigen (HLA)—essentially, their immune systems are primed to reject donor kidneys. The study aims to determine whether vonsetamig can safely decrease anti-HLA antibodies to make transplantation possible. Another trial is examining extended use of TARPEYO (delayed-release budesonide capsules) in patients with primary IgA nephropathy, a specific type of kidney disease where the immune system attacks the kidneys. Participants in this 19-month study will undergo urine tests, blood samples, and physical examinations to assess whether longer treatment provides additional benefits.

For children and adolescents, UCSF is testing empagliflozin, a medication originally developed for diabetes that may also help protect kidney function in young patients with CKD. In this study, participants aged 2 to 17 are randomly assigned to receive either empagliflozin or a placebo for 6 months, then both groups receive the active medication for an additional year. Participants visit the study site approximately 15 times and receive at least 5 phone or video calls from staff to monitor their health and any side effects.

Which Trials Focus on Kidney Transplants and Donor Safety?

Kidney transplantation offers the best long-term outcomes for people with end-stage kidney disease, but several barriers exist—including immune rejection and the safety of living donors. UCSF's trials address both concerns.

The APOLLO study (APOL1 Long-term Kidney Transplantation Outcomes Network) is examining how genetic variation in the apolipoprotein L1 gene affects transplant outcomes and living donor safety. This is particularly important because African Americans, Afro-Caribbeans, Hispanic Blacks, and Africans are more likely to carry APOL1 gene variants that increase kidney disease risk. By testing DNA from both kidney donors and recipients, researchers hope to improve how we predict and prevent transplant complications in these populations.

Another trial continues monitoring patients who previously received vonsetamig in an earlier study and then underwent kidney transplantation. This extension study tracks how the medication affects the body long-term and monitors transplant outcomes without administering additional study drug.

How Are These Trials Improving Access to Kidney Care?

Beyond new medications, UCSF is testing innovative delivery methods to reach underserved patients. One trial, titled "Achieving Chronic Care equiTy by leVeraging the Telehealth Ecosystem," examines whether a multi-level intervention can improve telehealth access for low-income patients managing chronic conditions like hypertension and diabetes—conditions that often lead to kidney disease. The intervention includes clinic-level practice facilitation and patient-level digital health coaching.

This approach recognizes a critical gap: many people with kidney disease don't have easy access to nephrology specialists, and transportation or work schedules can make in-person visits impossible. By combining telehealth technology with personalized coaching, researchers hope to demonstrate that remote care can be just as effective as traditional office visits for managing kidney health.

What Specific Kidney Conditions Are Being Studied?

The trials target several distinct kidney diseases and complications, each requiring different treatment approaches:

• IgA Nephropathy: Multiple trials are testing ravulizumab and other medications to reduce proteinuria (protein in the urine) and slow the decline in estimated glomerular filtration rate (eGFR), a measure of kidney function, in adults at risk of disease progression.
• Hyperphosphatemia in Children: Ferric citrate is being studied in children aged 6 to 18 with CKD stages 3 and 4 to assess whether it can reduce levels of fibroblast growth factor 23 (FGF23), a hormone that becomes elevated when kidneys can't properly regulate phosphate.
• Acute Kidney Injury During Heart Surgery: The ARTEMIS trial is testing whether a single dose of ravulizumab can reduce the risk of acute kidney injury (AKI) and major adverse kidney events (MAKE) in patients with CKD who undergo non-emergent cardiac surgery.

These conditions represent different pathways to kidney damage, which is why UCSF's portfolio of trials is so comprehensive. Some studies focus on slowing progression in people with mild to moderate kidney disease, while others target acute complications or specific immune-mediated diseases.

Who Can Participate in These Trials?

Eligibility varies by study. Most adult trials accept participants aged 18 and older, though some have upper age limits (such as the vonsetamig transplant trial, which enrolls up to age 70). Pediatric trials focus on children and adolescents, with age ranges specified for each study. Some trials are actively enrolling new participants, while others are in progress but not currently accepting new patients, and a few are accepting participants by invitation only.

If you or a family member has chronic kidney disease and are interested in participating, UCSF's clinical trials website lists detailed eligibility criteria, study locations, and contact information for each trial. Participation typically involves regular blood and urine tests, physical examinations, and periodic visits or phone calls to monitor health and side effects.

The breadth of UCSF's kidney disease research reflects the urgent need for better treatments. Chronic kidney disease affects millions of Americans, and while dialysis and transplantation can extend life, they come with significant burdens. These clinical trials represent hope for patients and families seeking to slow disease progression, improve transplant outcomes, and access care more easily.