Kidney Week

Abstract: TH-PO1236

Effect of Aprocitentan on Kidney Function in Patients with Hypertension, with or Without CKD

Session Information

• Late-Breaking Research Posters
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2202 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Schlaich, Markus P., Royal Perth Hospital Research Foundation, Medical School, University of Western Australia, Perth, Western Australia, Australia

Markus P. Schlaich, MD

• Mann, Johannes F., Universitatsklinikum Erlangen, Erlangen, BY, Germany

Johannes F. Mann, MD

• Clozel, Martine, Idorsia Pharmaceuticals Ltd, Allschwil, BL, Switzerland

Martine Clozel, MD, PhD

• Laurent, Johann, Idorsia Pharmaceuticals Ltd, Allschwil, BL, Switzerland

Johann Laurent, MSc

• Maresta, Alessandro, Idorsia Pharmaceuticals Ltd, Allschwil, BL, Switzerland

Alessandro Maresta, MD, DrMed

• Rossignol, Patrick, Universite de Lorraine, Nancy, France

Patrick Rossignol, MD

Background

CKD patients (pts) may experience marked annual estimated glomerular filtration rate (eGFR) reductions, e.g. a slope of -3.7 ml/min/1.73m² on placebo in the dapagliflozin-CKD trial. Resistant hypertension (RHT) pts are at high risk of CKD. Aprocitentan reduced blood pressure (BP) and urinary albumin-to-creatinine ratio (UACR) in RHT pts in the PRECISION trial. The effect on eGFR by baseline (BL) kidney function has not yet been described.
Objective: To analyze the effect of aprocitentan on eGFR (ml/min/1.73m² based on serum creatinine) by BL kidney function.

Methods

In PRECISION, 730 pts with confirmed RHT on standardized background therapy were randomized to aprocitentan 12.5mg, 25mg or placebo for 4 weeks. All then switched to aprocitentan 25mg for 32 weeks. We calculated acute eGFR change (weeks 0 – 4) for placebo and both doses of aprocitentan, and chronic eGFR slope (weeks 6 – 36, ml/min/1.73m²/ year) for aprocitentan 25mg, stratified by BL eGFR (≥60 'without CKD 3-4' vs <60 'with CKD 3-4').

Results

BP reduction from weeks 0 to 36 was -17.9 mmHg in pts with CKD 3-4 and –17.6 mmHg in pts without CKD 3-4. BL eGFR (SD) was 44.8 (11.6) and 85.4 (14.6) for pts with and without CKD 3-4, respectively. Acute eGFR changes were +1.0 (2.2%), +1.1 (2.5%) and -1.7 (-3.8%) with placebo, aprocitentan 12.5mg and 25mg for those with CKD 3-4, and -0.9 (-1.1%), -1.8 (-2.1%) and -2.7 (-3.1%) with placebo, aprocitentan 12.5mg and 25mg for those without CKD 3-4. The chronic slopes were +0.27 and +0.92 for pts with and without CKD 3-4, respectively.

Conclusion

In addition to substantial BP and UACR lowering, aprocitentan preserved a stable chronic eGFR slope in pts with and without CKD 3-4. These findings suggest nephroprotective effects of aprocitentan in CKD pts and warrant further investigation.