Developments in Chronic Kidney Disease treatment and value-based care

The landscape for chronic kidney disease (CKD) is evolving through both therapeutic advancements and shifts in healthcare delivery models. Emerging treatments in the pipeline include endothelin A receptor antagonists (ETAs), aldosterone synthase inhibitors (ASIs), and cell-based therapies aimed at slowing disease progression and delaying kidney failure. The introduction of generic SGLT2 inhibitors is expected to reduce costs while increasing the pressure on manufacturers to prove the clinical value of newer, more expensive therapies.

In the realm of healthcare administration, nephrologists at the American Society of Nephrology (ASN) Kidney Week 2026 noted that five years of federal value-based kidney care models have improved dialysis starts and transplant transitions. However, these benefits are being countered by shifting payment rules and the rapid growth of Medicare Advantage (MA). Changes to CMS models, including the early end of the Kidney Care First (KCF) option and payment reductions in the Comprehensive Kidney Care Contracting (CKCC) option, are prompting some practices to exit these programs.