A new drug called baxdrostat may help people who have both chronic kidney disease and uncontrolled high blood pressure.
According to early findings shared at the American Heart Association’s Hypertension Scientific Sessions 2025 and published in the Journal of the American Society of Nephrology, this medication could be a promising new tool for doctors treating these two serious and often connected conditions.
Chronic kidney disease and high blood pressure go hand-in-hand. If not controlled, one can make the other worse, creating a dangerous cycle. High blood pressure can damage the kidneys over time, while poor kidney function can raise blood pressure even more.
One hormone behind both problems is aldosterone, which makes the body hold on to sodium and water. This raises blood pressure and, over time, can stiffen blood vessels and scar the kidneys.
The purpose of this study was to see whether baxdrostat, which lowers aldosterone levels, could safely reduce blood pressure in people already taking strong medications but still not reaching healthy blood pressure levels.
Participants in the study had serious kidney disease and high blood pressure despite taking common treatments like ACE inhibitors or ARBs, which are drugs that also target hormones involved in blood pressure control.
At the start, participants had an average top blood pressure number (systolic) of 151, which is quite high. Lab tests showed significant kidney problems too. On average, they had 714 mg of the protein albumin in their urine (normal is under 30), and their kidney function was already reduced.
Out of 195 participants, 192 were randomly given either a low dose, a high dose of baxdrostat, or a placebo, along with their usual medications. After 26 weeks, those taking baxdrostat saw their systolic blood pressure drop by 8.1 points more than those taking the placebo. This drop is equal to about 5% and is considered a meaningful improvement.
Some side effects were reported. The most common was high potassium levels, which can happen with medications that affect the hormone system.
This occurred in 41% of people on baxdrostat, but most cases were mild. Serious side effects were seen in 9% of people taking baxdrostat and 3% of those on placebo, but there were no deaths or unexpected safety issues.
Importantly, researchers also looked at the amount of protein lost in the urine. High levels of albumin in urine are a sign of kidney damage. People taking baxdrostat had 55% less albumin in their urine than those on placebo. This suggests the drug may help slow down kidney damage as well.
Experts say this drug could be a breakthrough. Dr. Jamie Dwyer, who led the study, said these early results are encouraging and show that baxdrostat might help stop the cycle of worsening kidney function and rising blood pressure. Two larger trials are already underway to find out if the drug can truly slow kidney disease over the long term.
Dr. Jordana Cohen, an expert from the University of Pennsylvania, said it’s especially good news that people with kidney disease were included in this study. In the past, they were often left out of drug trials. This new class of medication might offer both heart and kidney protection for people with very few treatment options today.
Baxdrostat is still being tested and is not yet approved by the U.S. Food and Drug Administration, but if future studies confirm these results, it could become an important new treatment for many people with serious health problems.
The study is published in Journal of the American Society of Nephrology.
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