First-of-its-kind trial secures $4.93M to transform treatment of chronic kidney disease

An innovative study into the effect of combination treatments on chronic kidney disease (CKD), led by Associate Professor Sradha Kotwal, Program Head of Renal and Metabolic at The George Institute for Global Health and UNSW Sydney, has been awarded a $4.93 million grant through the Clinical Trials & Cohort Studies program in the Medical Research Future Fund.

The funds will support the international Phase III CAPTIVATE trial, which uses a unique adaptable design to test how different treatments slow kidney function decline in CKD patients receiving standard care, with the goal of rapidly discovering effective treatments. The flexible design allows for ongoing recruitment and patient follow-up, adding or removing treatments, adding new countries to the trial, and modifying patient selection based on responses. Five countries are involved in the study.

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While newer treatments like SGLT2-inhibitors, MRAs, and GLP-1 receptor agonists show promise in slowing kidney damage, none of them fully halt the disease. Combining these treatments has worked well in conditions like heart failure and high blood pressure, but we still don't know how to effectively use them together for CKD. That’s what we aim to discover through this trial, because the dynamic design allows us to quickly test and administer successful treatments.

By:

Associate Professor Sradha Kotwal

Program Head, Renal and Metabolic, The George Institute for Global Health

Chronic kidney disease (CKD) is a major global health issue, affecting over 1 in 10 Australians and 800 million people worldwide. CKD can lead to kidney failure, heart disease, and reduced quality of life. It often requires expensive and invasive treatments like dialysis or transplants, which many people, particularly those living in low to middle income countries, cannot access.

CKD contributed to approximately 21,800 deaths in Australia, or 11% of all deaths, in 2022¹. For people who reach the stage where they need dialysis, the median survival rate is about 50%, however this decreases with age².

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For too many people, CKD is a slow, silent decline toward kidney failure. Current standard care often feels like a waiting game rather than a solution. By the time patients reach the stage of needing dialysis, half won’t survive beyond five years. This trial is about changing that trajectory, so that CKD is no longer a life sentence, but a disease we can truly manage, to slow its course.

By:

Associate Professor Sradha Kotwal

Program Head, Renal and Metabolic, The George Institute for Global Health

References

1. Australian Institute of Health and Welfare. Chronic kidney disease: Australian facts, Mortality [Internet]. Australian Institute of Health and Welfare. 2023. Available from: https://www.aihw.gov.au/reports/chronic-kidney-disease/chronic-kidney-disease/contents/mortality

2. Australia & New Zealand Dialysis & Transplant Registry. Chapter 3: Mortality & End Stage Kidney Disease. 2019. Available from: https://www.anzdata.org.au/wp-content/uploads/2019/09/c03_mortality_2018_ar_2019_v1.0_20191202.pdf