CCXI Renal Drug -
In renal failure there are 3 primary things that matter:
a) Proteinurea - this is by far the easiest to measure and to drug, but the prognostic values (as a drug efficacy biomarker) is extremely suspect. It is a measure of how much your kidneys are leaking.
b) GFR (or eGFR) - this is harder to change, but is often the primary way in which it is decided whether to start dialysis. It is also a measure of how much your kidneys are unable to pump out toxins (i.e. a measure of how miserable you feel).
c) Hyperkalemia - this is generally an acute reaction to insult. E.g. the ACEs and ARBs, which are SOC for renal drugs, create a spike in the population of hyperkalemia events. But note that because the decision on whether to start dialysis is very non-standardized, many patients start permanent (instead of temporary) dialysis at a hyperkalemia event.
As for FSGS (and CCXI) - multiple companies are now pursuing FSGS because it is the most proteinuric of the renal diseases and their drugs seem to 'treat' the proteinurea. But it far from clear that this provides long term clinical benefit since they may provide no benefit in GFR (as CCXI didn't in their DN RCT) or harm GFR.
