Targeting Inflammation in CKD

Chronic systemic inflammation, triggered by innate immune system activation, is a key driver of both chronic kidney disease and associated atherosclerosis and cardiovascular disease. Directly targeting inflammatory pathways has emerged over the past 15 years as a novel approach under active investigation to reduce atherosclerotic cardiovascular disease risk in patients with chronic kidney disease and to slow kidney disease progression. Recent and ongoing clinical trials in patients with kidney disease include targeting interleukin-1 and the interleukin-1 receptor, interleukin-6 and the interleukin-6 receptor, the NLRP3 inflammasome, nuclear factor erythroid 2-related factor 2, and senolytics. As we await results of ongoing phase 3 clinical trials, numerous challenges and considerations remain for both research and clinical implementation of anticytokine therapies.