Testing Baxdrostat in High-Risk Kidney Patients.

The trial was designed to evaluate whether baxdrostat could safely improve blood pressure control when added to standard care in people with chronic kidney disease and uncontrolled hypertension. The participants had kidney disease serious enough that they were considered likely to face kidney failure or require a transplant during their lifetime.

Their blood pressure remained high even though they were already taking either an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin receptor blocker (ARB). These commonly used medicines act on a hormone system that helps control blood pressure.

At the start of the study, participants had an average systolic (top number) blood pressure of 151 mm Hg despite treatment. Laboratory tests also showed clear evidence of kidney disease. Their average urine albumin level was 714 mg/gm of creatinine. Levels of 30 or higher may signal chronic kidney disease. Their average estimated glomerular filtration rate (eGFR, a key indicator of kidney function) was 44mL/min/1.73. Persistent levels below 60 suggest chronic kidney disease.

The study enrolled 195 people, and 192 were randomly assigned to receive low-dose baxdrostat (0.5 mg-1 mg), high-dose baxdrostat (2 mg-4 mg), or a placebo in addition to standard care. Three people ended participation early because of adverse events, their own decision to leave the study, or other reasons.