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Chronic Kidney Failure

Nephrology
5
Pipeline Programs
11
Companies
11
Clinical Trials
1 recruiting
0
Approved Products

Pipeline by Development Stage

Preclinical
Phase 1
Phase 1/2
Phase 2
Phase 2/3
Phase 3
On Market
0
3
0
0
0
1
1
Early DiscoveryClinical DevelopmentMarket

Nephrology is a $36.6B mature market dominated by cardiometabolic crossover drugs with limited pure renal innovation.

$36.6B marketMature→ Stable30 products15 companies

Key Trends

  • GLP-1 agonists and SGLT2 inhibitors dominate (69% of spending) due to dual cardio-renal benefits
  • Patent cliffs approaching 2026-2030 create generic conversion risk for blockbuster franchises
  • Pipeline activity remains robust (2,785 trials) but concentrated in early-phase basic research

Career Verdict

Nephrology offers stable employment in commercial and medical affairs roles, but limited growth upside due to mature blockbuster dependency and declining pure renal research focus.

AI-generated market analysis based on FDA, CMS, ClinicalTrials.gov, and hiring data

Market Leaders

#1OZEMPICStable
$9.2B
Novo Nordisk·Peak12.4yr
#2JARDIANCEStable
$8.8B
Boehringer Ingelheim·Peak8.6yr
#3TRULICITYStable
$7.4B
Eli Lilly and Company·Peak
#4FARXIGAStable
$4.3B
AstraZeneca·Peak15.4yr

Drug Class Breakdown

Glucagon-like Peptide-1 (GLP-1) Agonists
$16.6B(45%)

cardiometabolic dominance

Sodium-Glucose Transporter 2 Inhibitors
$8.8B(24%)

cardioprotective expansion

SGLT2 Inhibitors (dapagliflozin class)
$4.3B(12%)

heart failure crossover

Adrenergic Beta3-Agonists
$3.0B(8%)

overactive bladder niche

Dipeptidyl Peptidase 4 Inhibitors
$1.3B(4%)

declining relevance

Career Outlook

Stable

Nephrology careers are stable but not expanding; the field is supported by blockbuster drugs (GLP-1s, SGLT2i) that face patent cliffs between 2026–2041, creating near-term employment security but long-term uncertainty. Commercial and medical affairs roles dominate hiring, while R&D investment is limited to niche mechanisms (complement inhibition, gene therapy). Career progression depends on specialization in medtech, diagnostics, or orphan nephrology rather than traditional pharma blockbuster development.

Breaking In

Target medtech platforms (Outset, Fresenius) or biotech innovators (Vertex, Calyxo) over traditional pharma; nephrology offers job stability and clinical depth but limited growth trajectory in pure pharmaceutical roles.

For Experienced Professionals

Leverage cardiometabolic expertise to span diabetes, CKD, and HF franchises; position for transition to orphan nephrology (ADPKD, FSGS, IgA) where innovation and valuation multiples are highest.

In-Demand Skills

Renal endpoints and biomarkers (eGFR, albuminuria)Cardio-renal crossover knowledge (diabetes + CKD + HF)Medtech systems expertise (dialysis, transplantation platforms)Medical affairs and key opinion leader management

Best For

Medical Science Liaison (renal specialists)Commercial Manager (established nephro franchise)Clinical Development Manager (rare kidney disease)Real-world evidence analyst (CKD outcomes)

Hiring Landscape

$108K–$330K

Nephrology hiring is concentrated in commercial roles (58 positions, $108K avg) and medical affairs (12 positions, $330K avg), reflecting mature market dynamics. Top hiring companies are innovative platforms (Vertex: 41 jobs) and medtech (Outset: 21 jobs), not traditional pharma. Salary compression in commercial roles suggests commoditization.

124
Open Roles
5
Companies Hiring
4
Departments

Top Hiring Companies

Vertex Pharmaceuticals
41Growing
Outset Medical
21Growing
Calyxo
20Growing
Biogen
8Stable
AstraZeneca
5Stable

By Department

Commercial(47%)
$108K
Medical Affairs(10%)
$330K
Clinical Excellence(6%)
$140K
Quality Assurance(4%)
$201K

Hiring favors medtech and biotech platforms over traditional pharma; medical affairs offers premium compensation but limited volume; commercial roles are abundant but underpaid relative to other therapeutic areas.

Competitive Landscape

11 companies ranked by most advanced pipeline stage

Pfizer
PfizerNEW YORK, NY
1 program
1
PPV23 vaccination or PCV13 vaccinationPhase 41 trial
Active Trials
NCT02492438Completed154Est. Mar 2014
Human BioSciences
Human BioSciencesWV - Martinsburg
1 program
1
training on ergonomic bicyclePhase 31 trial
Active Trials
NCT02418065Unknown120Est. Apr 2017
Baxter
BaxterCosta Rica - Cartago
6 programs
1
Decision AidPhase 1
Cartridge blood setN/A
Ease of Use and Blood Clotting for the Gambro Polyflux HD-C4 Big DialyzerN/A
Evodial hemodialysers and Evodia blood linesN/A
MCO-Ci 400N/A
+1 more programs
Sharp Therapeutics
Sharp TherapeuticsPA - Pittsburgh
1 program
1
MK-2828Phase 1
MSD
MSDIreland - Ballydine
1 program
1
MK-2828Phase 11 trial
Active Trials
NCT07348237Recruiting24Est. Aug 2026
Baxter International
6 programs
Cartridge blood setN/A
Ease of Use and Blood Clotting for the Gambro Polyflux HD-C4 Big DialyzerN/A
Evodial hemodialysers and Evodia blood linesN/A
MCO-Ci 400N/A
Theranova 400 DialyzerN/A
+1 more programs
Active Trials
NCT01671228Completed488Est. Mar 2014
Vantive
VantiveIL - Deerfield
5 programs
Cartridge blood setN/A1 trial
Ease of Use and Blood Clotting for the Gambro Polyflux HD-C4 Big DialyzerN/A1 trial
Evodial hemodialysers and Evodia blood linesN/A1 trial
MCO-Ci 400N/A1 trial
Theranova 400 DialyzerN/A1 trial
Active Trials
NCT00804453Completed16Est. Nov 2008
NCT00659724Completed33Est. May 2008
NCT00781690Completed53Est. Feb 2010
+2 more trials
AbbVie
AbbVieNORTH CHICAGO, IL
1 program
Paricalcitol Oral Therapy in Predialysis CKD Patients. The Greek ExperienceN/A
Abbott
AbbottABBOTT PARK, IL
1 program
Paricalcitol Oral Therapy in Predialysis CKD Patients. The Greek ExperienceN/A1 trial
Active Trials
NCT01083186Completed500Est. Jan 2012
Innovation Pharmaceuticals
1 program
lanthanum carbonateN/A1 trial
Active Trials
NCT01581996Completed9Est. May 2017
Merck & Co.
Merck & Co.RAHWAY, NJ
1 program
MK-2828PHASE_1

Trial Timeline

Clinical trial activity over time

2021
2022
2023
2024
2025
2026
PfizerPPV23 vaccination or PCV13 vaccination
Human BioSciencestraining on ergonomic bicycle
MSDMK-2828
Baxter InternationalDecision Aid
VantiveTheranova 400 Dialyzer
VantiveMCO-Ci 400
Innovation Pharmaceuticalslanthanum carbonate
AbbottParicalcitol Oral Therapy in Predialysis CKD Patients. The Greek Experience
VantiveCartridge blood set
VantiveEvodial hemodialysers and Evodia blood lines
VantiveEase of Use and Blood Clotting for the Gambro Polyflux HD-C4 Big Dialyzer

Clinical Trials (11)

Total enrollment: 1,770 patients across 11 trials

NCT02492438PfizerPPV23 vaccination or PCV13 vaccination

13 Valent Pneumococcal Conjugate Vaccine in Chronic Dialysis Patients

Start: Feb 2013Est. completion: Mar 2014154 patients
Phase 4Completed
NCT02418065Human BioSciencestraining on ergonomic bicycle

Multimodal Therapeutic Approach in Undernourished Maintenance Hemodialysis Patients (AMERICANO)

Start: Dec 2013Est. completion: Apr 2017120 patients
Phase 3Unknown
NCT07348237MSDMK-2828

A Clinical Trial of MK-2828 in People With Kidney Disease (MK-2828-006)

Start: Mar 2026Est. completion: Aug 202624 patients
Phase 1Recruiting
NCT01671228Baxter InternationalDecision Aid

Developing and Evaluating the Yorkshire Dialysis Decision Aid

Start: Jan 2011Est. completion: Mar 2014488 patients
Phase 1Completed
NCT05309291VantiveTheranova 400 Dialyzer

Theranova Randomized, Controlled, Trial (RCT) in China

Start: Jun 2022Est. completion: Jul 2023323 patients
N/ACompleted
NCT02084381VantiveMCO-Ci 400

PERCI- Medium Cut Off (MCO)

Start: Feb 2014Est. completion: Feb 201550 patients
N/ACompleted
NCT01581996Innovation Pharmaceuticalslanthanum carbonate

Fosrenol and Phosphorus Balance - Lanthanum Carbonate

Start: Mar 2012Est. completion: May 20179 patients
N/ACompleted
NCT01083186AbbottParicalcitol Oral Therapy in Predialysis CKD Patients. The Greek Experience

Paricalcitol Oral Therapy in Predialysis CKD Patients. The Greek Experience

Start: Jun 2009Est. completion: Jan 2012500 patients
N/ACompleted
NCT00804453VantiveCartridge blood set

Evaluation of the Biocompatibility of Cartridge Blood Set Versus Standard Blood Line

Start: Nov 2008Est. completion: Nov 200816 patients
N/ACompleted
NCT00781690VantiveEvodial hemodialysers and Evodia blood lines

Reduction of Heparin Dose in Dialysis With Evodial System

Start: Sep 2008Est. completion: Feb 201053 patients
N/ACompleted
NCT00659724VantiveEase of Use and Blood Clotting for the Gambro Polyflux HD-C4 Big Dialyzer

Ease of Use and Blood Clotting for the Gambro Polyflux HD-C4 Big Dialyzer

Start: Mar 2008Est. completion: May 200833 patients
N/ACompleted

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Phase Legend

Preclinical— Lab & animal studies
Phase 1— Safety & dosing
Phase 2— Efficacy testing
Phase 3— Large-scale trials
On Market— Approved & available

Key Insights

1 late-stage (Phase 3) programs, potential near-term approvals
1 actively recruiting trials targeting 1,770 patients
11 companies competing in this space

Related Indications

Chronic Kidney Disease(220)End Stage Renal Disease(203)Renal Impairment(142)Kidney Transplantation(136)Chronic Kidney Diseases(71)Renal Insufficiency(66)Acute Kidney Injury(66)Kidney Diseases(46)Renal Transplantation(45)Kidney Transplant(41)

The information on this page is for informational purposes only and should not be used as a substitute for professional medical advice. Drug information is sourced from FDA, DailyMed, and other government databases. Adverse event data from FAERS does not establish causation. Always consult a healthcare professional for medical decisions.