What is the role of Renakult in the management of Chronic Kidney Disease (CKD)?

Role of Renakult in Chronic Kidney Disease Management

Renakult is not mentioned in any of the current clinical guidelines or research evidence for chronic kidney disease (CKD) management, and therefore cannot be recommended as part of standard CKD care.

Evidence-Based CKD Management

The management of CKD should focus on evidence-based interventions that have been proven to slow disease progression and reduce mortality. Current guidelines recommend:

First-Line Therapies

• Renin-Angiotensin System Blockers: ACE inhibitors or ARBs are recommended as first-line therapy for patients with albuminuria >30 mg/day 1, 2
• SGLT2 Inhibitors: Recommended for patients with type 2 diabetes and CKD with eGFR ≥20 mL/min/1.73 m², especially with albuminuria ≥200 mg/g creatinine 1, 2
• Finerenone: A non-steroidal mineralocorticoid receptor antagonist that has shown benefits in reducing CKD progression, cardiovascular risks, and death in patients with diabetic kidney disease 1

Blood Pressure Control

• Target <140/90 mmHg for patients without albuminuria
• Target <130/80 mmHg for patients with albuminuria (≥30 mg/24 hours) or diabetes 1, 2

Lifestyle Modifications

• Reduced sodium intake (<2g/day)
• Maintaining healthy body weight (BMI 20-25 kg/m²)
• Regular physical activity (150 minutes/week)
• Smoking cessation
• Plant-based "Mediterranean-style" diet 2, 3

Disease-Modifying Medications in CKD

The concept of disease modification in CKD focuses on interventions that positively affect kidney disease trajectory by slowing or reversing kidney damage and functional decline 1. Currently recognized disease-modifying medications include:

1. ACE inhibitors/ARBs
2. SGLT2 inhibitors
3. GLP-1 receptor agonists
4. Finerenone

These medications have demonstrated efficacy in large clinical trials such as CREDENCE, DAPA-CKD, EMPA-REG OUTCOME, and others 1.

Combination Therapy Considerations

For high-risk CKD patients with significant residual risk (particularly those with high UACR), combining individual agents with different mechanisms of action is advisable 1. The optimal approach includes:

• Base therapy with ACE inhibitors or ARBs
• Addition of SGLT2 inhibitors in patients with type 2 diabetes
• Consideration of finerenone in appropriate candidates
• Regular reassessment and medication review

Monitoring Recommendations

Regular monitoring of kidney function is essential:

• Annual assessment of eGFR and albuminuria for low-risk patients
• More frequent monitoring (3-4 times per year) for high-risk patients (G4-G5 or A3 categories) 2

Conclusion

While various evidence-based therapies exist for CKD management, Renakult is not mentioned in any current clinical guidelines or research evidence. Clinicians should focus on implementing proven interventions such as RAAS blockers, SGLT2 inhibitors, and finerenone, along with appropriate lifestyle modifications to optimize outcomes in CKD patients.