Adding the novel medication baxdrostat to standard care may help manage high blood pressure and delay the progression of kidney disease in people with chronic kidney disease and uncontrolled high blood pressure, according to preliminary research presented at the American Heart Association's Hypertension Scientific Sessions 2025. The study was simultaneously published in the Journal of the American Society of Nephrology. Results from the FigHTN Phase 2 clinical trial showed baxdrostat, a new medication that inhibits the production of the hormone aldosterone, lowered systolic blood pressure by about 5% when added to the existing medications taken by people with chronic kidney disease and who also have uncontrolled high blood pressure.
The analysis also found that baxdrostat lowered the loss of albumin in the urine, which is a marker of kidney and cardiovascular risk, by 55% compared to placebo, suggesting that this medication may help delay the progression of kidney disease. Chronic kidney disease and high blood pressure are closely linked and, when not managed appropriately, can lead to serious outcomes such as heart attack, stroke, heart failure and progression to kidney failure. Aldosterone, a hormone produced by the adrenal glands, can play a role in both high blood pressure and chronic kidney disease. Aldosterone causes sodium to be retained, which increases water retention and blood pressure.
The study included 195 people with an average age of 66 years. Of the participants, 32% were women, 40% were non-Hispanic white and 80% had Type 2 diabetes. The study was conducted at 71 sites in the United States. After 26 weeks, the average systolic blood pressure had fallen 8.1 mm Hg more in participants receiving either dose of baxdrostat than in those receiving the placebo, a reduction of about 5%. High potassium levels in the blood, a known side effect of medications that block the renin-angiotensin-aldosterone system, occurred in 41% of participants on baxdrostat and 5% of those on placebo. Most cases were mild to moderate.
There were no deaths or unanticipated adverse events during the trial, however, 9% of participants taking baxdrostat and 3% of those in the placebo group experienced a serious adverse event. These findings suggest the potential for baxdrostat to improve longer-term health outcomes like kidney and cardiovascular conditions and reduce the need for higher-cost care for people with uncontrolled high blood pressure and chronic kidney disease. The reduction in urine albumin gives researchers hope that baxdrostat may also help delay kidney damage. This potential is now being tested in two large Phase 3 trials to determine if baxdrostat delays the progression of kidney disease.
Baxdrostat is in a class of medications that inhibit the production of aldosterone and are being tested for their ability to treat conditions such as high blood pressure, chronic kidney disease and heart failure. Baxdrostat is not approved for any use by the U.S. Food and Drug Administration. The study was funded by AstraZeneca, developer of baxdrostat. The implications of this research are significant given the close link between chronic kidney disease and hypertension, which together represent a major public health burden with serious cardiovascular and renal complications when uncontrolled.
