January 08, 2026
9 min read
Key takeaways:
- Disease remission is now achievable, and cure might be on the horizon, according to a speaker at ASN Kidney Week.
- Data on new therapies for IgA nephropathy, fish oil for risk reduction and more were presented.
ASN Kidney Week, held in November, featured leading-edge science in kidney care, with evidence supporting new drugs to treat immunoglobulin A nephropathy, address chronic kidney disease in specific populations and reduce comorbidity risks as well as innovations in dialysis.
“Yes, we can … cure kidney diseases” was the title of the state-of-the-art lecture for the opening plenary session. During his presentation, Vlado Perkovic, MB, PS, PhD, scientia professor and provost at the University of New South Wales in Sydney, traced the goals of kidney care from slowing disease progression in the 1990s to today achieving remission or even reversal, with a greater understanding of the mechanism underlying kidney disease.
Image: Vlado Perkovic, MB, PS, PhD.
“We have made huge progress in preventing kidney failure with a large number of highly effective treatments now available and more in the pipeline. Our tools are now incredibly powerful,” Perkovic told Healio.
“We can now achieve remission for many patients, where they lose similar amounts of kidney function each year to the general population. To me, cure implies that no further treatment is required, and we are not there yet, but for the first time, realistic pathways to cure are potentially apparent, for example, using gene-based therapies,” he said.
This Healio Exclusive highlights a roundup of key trials and updates from this year’s meeting along with expert perspective and reaction.
“Kidney Week was a blast this year,” Crystal A. Gadegbeku, MD, FASN, chair of the department of kidney medicine in the Medical Specialties Institute in the Cleveland Clinic Health System, told Healio. “I think we’ve finally gotten past the ‘pinch me, am I dreaming’ stage of the excitement of new therapies and innovation in our field with this meeting.”
ORIGIN 3
The novel drug atacicept (Vera Therapeutics) was associated with significant reductions in proteinuria vs. placebo with comparable safety and no evidence of immunosuppression for patients with immunoglobulin A nephropathy (IgAN), according to data from a 36-week prespecified interim analysis of the ORIGIN 3 trial.
Richard Lafayette
“[This] is exciting times, and the atacicept data adds beautifully to the building momentum of being able to offer highly effective care for IgAN,” Richard Lafayette, MD, FACP, professor of medicine in nephrology and director of the Stanford Glomerular Disease Center at Stanford University Medical Center, told Healio.
Atacicept is a human transmembrane activator and calcium-modulator and cyclophilin ligand interactor-Fc fusion protein that inhibits B-cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL).
ORIGIN 3 is a 2-year multinational, randomized, double-blind, placebo-controlled clinical trial evaluating the efficacy and safety of atacicept for patients with IgAN. In the interim efficacy analysis, 106 adults with IgAN on biopsy and high risk for disease progression were randomly assigned to a 150 mg weekly atacicept injection and 97 patients were assigned to placebo. Injections were self-administered at home. The safety analysis included 214 patients in the atacicept group.
At week 36, the atacicept group saw a significant 45.7% reduction from baseline in urine protein-to-creatinine ratio vs. 6.8% for the placebo group (geometric mean between-group difference in reduction = 41.8%; 95% CI, 28.9%-52.3%). In addition, the atacicept group had significant reductions from baseline vs. placebo in galactose-deficient IgA1 (68.3% vs. 2.9%; geometric mean between-group difference in reduction = 67.4%; 95% CI, 63.8%-70.6%) and hematuria (81% vs. 20.7%; OR = 19.1; 95% CI, 7.3-50). Data on change in eGFR were not presented “per FDA recommendation to sponsors of IgAN registration trials,” Lafayette said.
Adverse events were mostly mild or moderate in severity and occurred in 59% of the atacicept group and 50% of the placebo group. The rate of severe adverse events was lower in the atacicept group, according to Lafayette.
“We now have two phase 3 trials of drugs that target the cytokine[s] APRIL and … BAFF that are very important for the development and maturation of B cells, particularly IgA-producing cells,” Ali G. Gharavi, MD, professor of nephrology and hypertension at Columbia University, told Healio. Gharavi was not involved in the trials. “[These] trials are really showing efficacy with a 30% to 50% reduction in proteinuria in patients with IgAN.”
Along with other available and emerging therapies for IgAN, “now the questions in the field are going to be how are we going to select these drugs for patients? Which patient will benefit most from these disease-modifying therapies vs. these more generic therapies that reduce nephron loss? Are we going to combine them? Are we going to use them in sequence, or are we going to use them in combination, and for how long? This is really an exciting time,” Gharavi said.
Read Healio’s full coverage of this trial.
FINE-ONE
Use of finerenone (Kerendia, Bayer) for 6 months was safe and associated with a significant 25% decrease in albuminuria for adults with type 1 diabetes and CKD, according to data from the phase 3 FINE-ONE trial.
Hiddo J. L. Heerspink, PhD
“FINE-ONE is the first global trial evaluating the efficacy and safety of finerenone in a high-risk population with CKD and type 1 diabetes,” Hiddo J. L. Heerspink, PhD, professor and clinical pharmacologist in the department of clinical pharmacy and pharmacology at the University Medical Center Groningen in the Netherlands, told Healio. “These data indicate the potential of finerenone to reduce the risk of kidney failure and CVD in high-risk patients with type 1 diabetes and CKD.”
Finerenone, a selective mineralocorticoid receptor antagonist, was associated with reduced risks for kidney and cardiovascular events for adults with CKD and type 2 diabetes in the FIDELITY trial. Finerenone is currently approved for use by adults with type 2 diabetes and CKD to prevent CKD progression, kidney failure and CVD-related death.
In the FINE-ONE trial, researchers randomly assigned adults with CKD and insulin-treated type 1 diabetes to 10 mg to 20 mg finerenone daily (n = 120) or placebo (n = 122) for 6 months. The primary outcome was change from baseline in urine albumin-to-creatinine ratio (UACR), used as a bridging biomarker “to translate evidence from type 2 diabetes to type 1 diabetes,” Heerspink said.
“Finerenone has already [been] demonstrated to reduce the risk of kidney failure in type 2 diabetes and CKD, and subsequent analyses from the FIDELITY program showed that 87% of this protective effect is explained by the reduction in albuminuria,” Heerspink said. “Given the strong and consistent associations between treatment effects on albuminuria and treatment effects on kidney failure, I believe that albuminuria is a validated surrogate outcome. It should be used in particular in settings where large outcome trials are difficult to conduct, such as in type 1 diabetes and CKD.”
In FINE-ONE, the finerenone group saw a 34% reduction from baseline in UACR vs. 12% for the placebo group (least-squares geometric mean ratio = 0.75; 95% CI, 0.65-0.87).
Incidences of treatment-emergent adverse events and serious treatment-emergent adverse events were similar with finerenone and placebo. Finerenone was associated with a “small” increase in serum potassium compared with placebo — a maximum difference of 0.14 mmol/L, according to Heerspink.
Use of finerenone has been associated with a reversable early decline in eGFR, which was observed in FINE-ONE.
“What is really fascinating is that after 30 years we have a new treatment in type 1 diabetes in the FINE-ONE study, which uses finerenone to reduce proteinuria, and you can do it safely in a type 1 diabetic population,” Gadegbeku, who was not involved with the study, told Healio. “We’re really in an era of innovation.”
Read Healio’s full coverage of this trial.
PISCES
Fish oil supplementation showed efficacy in reducing risks for CV events for patients on dialysis, according to data from the PISCES trial.
Use of omega-3 supplements, a type of polyunsaturated fatty acids that includes eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), has been explored for potential CV health benefits, according to Charmaine E. Lok, MD, MSc, FRCPC, professor of medicine at the University of Toronto and senior scientist at the Toronto General Hospital Research Institute. However, supplementation in a patient population on hemodialysis has not been established, despite patients on dialysis having a 20 times greater risk for CV death, according to Lok.
Charmaine E. Lok
“There really is no recommendation in terms of should you take fish oil supplementation or not, particularly in capsule form,” Lok said during a press briefing.
Lok and colleagues randomly assigned adults on hemodialysis into two groups: 610 received 4 g steam-deodorized, citrus-flavored omega-3 fatty acids, and 618 received citrus-flavored corn oil placebo. The fish oil group received four 1 g capsules containing 1.6 g EPA and 0.8 g DHA.
The primary outcome focused on a composite of severe CV events — myocardial infarction resulting in amputation, stroke, peripheral vascular disease and CVD death. The secondary endpoints were noncardiac cause death, individual CV event rates and all-cause mortality.
After a follow-up period of 3.5 years, the fish oil group had a significantly lower rate of CV events compared with the placebo group (0.31 per 1,000 patient-days vs. 0.61; HR = 0.57; 95% CI, 0.47-0.7).
Including noncardiac causes of death, the fish oil group had a lower mortality rate compared with placebo (HR = 0.77; 95% CI, 0.65-0.9).
For individual risk factors, the fish oil group had reduced risks for CV death (HR = 0.55; 95% CI, 0.4-0.75), myocardial infarction (HR = 0.56; 95% CI, 0.4-0.8), peripheral vascular disease (HR = 0.57; 95% CI, 0.38-0.86), stroke (HR = 0.37; 95% CI, 0.18-0.76) and all-cause mortality (HR = 0.73; 95% CI, 0.61-0.87).
The data show daily fish oil supplementation reduced the risk for CVD for patients on hemodialysis, according to Lok.
“We have a lot of data, and I think there’s a lot of work for us to unravel the effects and why they occurred,” Lok told Healio.
“[This is] a remarkable study. It’s certainly the first time in a long time that a nephrology study has shown such a dramatic effect on cardiovascular outcomes,” Jeffrey S. Berns, MD, professor of medicine (renal, electrolyte and hypertension) at the Hospital of the University of Pennsylvania and the Presbyterian Medical Center of Philadelphia, told Healio. Berns was not involved in the trial. “We’re talking … about ways to implement this for dialysis patients given the dramatic effects that were observed.”
Read Healio’s full coverage of this trial.
LIBERATE-D
Nearly two-thirds of patients on a conservative hemodialysis strategy recovered kidney function after hospital discharge compared with patients on hemodialysis three times a week, according to data from the LIBERATE-D trial.
Chi-yuan Hsu
“There’s been a lot of trials about how to start dialysis … but no study about how to stop,” Chi-yuan Hsu, MD, MSc, chief of the division of nephrology at University of California-San Francisco Health, said during a press briefing. “We hypothesize the conventional way we do dialysis … actually impairs renal recovery.”
Hsu and colleagues randomly assigned 220 adults with AKI who were hemodynamically stable equally into two groups. One group underwent traditional hemodialysis three times a week until reaching urine creatinine clearance greater than 20 mL per minute or urine output greater than 2 L per day with diuretics or 1 L per day without. The other group initiated dialysis only if certain criteria were met: serum urea nitrogen level greater than 112 mg/dL, hyperkalemia above 6 mmol/L or arterial blood gas pH less than 7.15.
Kidney function recovery after hospital discharge, defined as 14 consecutive days without dialysis, served as the primary endpoint. Secondary endpoints included the number of dialysis sessions per week and the number of dialysis-free days up to 28 days.
Results showed more patients in the conservative dialysis group (64.2%) recovered kidney function compared with the traditional dialysis group (50.5%) at discharge, but the association was not statistically significant in the model adjusted for eGFR and demographic differences. Patients on conservative dialysis underwent fewer sessions than the traditional dialysis group (median, 1.8 vs. 3.1), had a faster time to kidney function recovery (2 days vs. 8.5 days), had more consecutive dialysis-free days (21 days vs. 5 days) and had fewer hypotension events (69 vs. 97).
“We hope that this would really nudge doctors to think about not just putting people on dialysis three times a week, but to really carefully consider the need for dialysis each time,” Hsu told Healio. “Some physicians may consider it more hazardous or time-consuming, but we think it’s a relatively safe thing to do with proper monitoring.”
Read Healio’s full coverage of this trial.
For more information:
Hiddo J. L. Heerspink, PhD, can be reached at h.j.lambers.heerspink@umcg.nl.
Chi-yuan Hsu, MD, MSc, can be reached at nephrology@healio.com.
Richard Lafayette, MD, FACP, can be reached at czar@stanford.edu.
Charmaine E. Lok, MD, MSc, FRCPC, can be reached at nephrology@healio.com.
Sources/Disclosures
References:
- Heerspink HJL, et al. TH-OR082. Presented at: ASN Kidney Week; Nov. 5-9, 2025; Houston.
- Hsu C, et al. FR-OR083 Presented at: ASN Kidney Week; Nov. 5-9, 2025; Houston.
- Lafayette R. TH-OR083. Presented at: ASN Kidney Week; Nov. 5-9, 2025; Houston.
- Lafayette R, et al. N Engl J Med. 2025;doi:10.1056/NEJMoa2510198.
- Liu KD, et al. JAMA. 2025;doi:10.1001/jama.2025.21530.
- Lok CE. FR-OR082. Presented at: ASN Kidney Week; Nov. 5-9, 2025; Houston.
- Lok CE, et al. N Engl J Med. 2025;doi:10.1056/NEJMoa2513032.
Disclosures:
Berns and Lok report no relevant financial disclosures. The FINE-ONE trial was funded by Bayer. The ORIGIN 3 trial was funded by Vera Therapeutics. Gadegbeku reports being an advisor for Maze Therapeutics and Vertex Pharmaceuticals. Gharavi reports consulting for Natera, Novartis and Vera Therapeutics. Heerspink reports consulting for Alexion, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Dimerix, Eli Lilly, Novartis, Novo Nordisk, Roche and Travere; and receiving research support from AstraZeneca, Bayer, Boehringer Ingelheim, Novo Nordisk and travel support from AstraZeneca, Bayer and Eli Lilly. Hsu reports receiving grants from NIH/NIDDK during the conduct of the study. Lafayette reports serving as a researcher or consultant for Amgen, BeiGene, Biogen, Calliditas, Kyverna, Otsuka, Roche, Vera and Vertex.
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