A new medication called baxdrostat may help people with chronic kidney disease control high blood pressure that has been difficult to manage with standard treatments.
The findings, presented at the American Heart Association’s Hypertension Scientific Sessions 2025 and published in the Journal of the American Society of Nephrology, suggest that the drug could not only lower blood pressure but also slow kidney damage.
Chronic kidney disease (CKD) and high blood pressure are closely linked, each making the other worse.
High blood pressure puts strain on the kidneys, and as kidney function declines, blood pressure often rises further.
This cycle can lead to serious complications such as heart attacks, strokes, heart failure, and eventually kidney failure requiring dialysis or transplant.
One key player in this cycle is aldosterone, a hormone made by the adrenal glands. Aldosterone causes the body to retain sodium and water, which raises blood pressure.
Too much of it over time can stiffen blood vessels, damage the heart, and scar the kidneys. Baxdrostat works by blocking aldosterone production, offering a new way to treat both blood pressure and kidney damage.
The study included 195 adults with an average age of 66. All participants had chronic kidney disease and uncontrolled high blood pressure, despite already taking standard medications such as ACE inhibitors or angiotensin receptor blockers.
Their average systolic blood pressure—the top number in a reading—was 151 mmHg at the start of the study, well above healthy levels.
Participants were randomly assigned to receive either a low or high dose of baxdrostat or a placebo, in addition to their regular medications.
After 26 weeks, those taking baxdrostat saw their systolic blood pressure drop an average of 8.1 mmHg more than those on placebo, a reduction of about 5 percent.
Importantly, the drug also cut the level of protein in urine—a marker of kidney damage—by more than half compared to placebo.
Although side effects did occur, most were manageable. High potassium levels, a known issue with drugs that block the renin-angiotensin-aldosterone system, were more common in the baxdrostat group but were usually mild or moderate. Serious side effects occurred in 9 percent of baxdrostat users compared to 3 percent of placebo users, and no deaths or unexpected safety problems were reported.
Lead author Dr. Jamie Dwyer of the University of Utah Health called the findings encouraging for patients who face the double burden of kidney disease and uncontrolled hypertension.
Experts not involved in the study, including Dr. Jordana Cohen of the University of Pennsylvania, said the results are particularly significant because patients with kidney disease are often excluded from clinical trials.
Two large Phase 3 studies are now underway to determine whether baxdrostat can delay progression of kidney disease.
If successful, the drug could represent a breakthrough treatment, offering hope for millions of people worldwide who struggle with both kidney disease and high blood pressure.
