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End Stage Kidney Disease

Nephrology
4
Pipeline Programs
7
Companies
8
Clinical Trials
2 recruiting
1
Approved Products

Pipeline by Development Stage

Preclinical
Phase 1
Phase 1/2
Phase 2
Phase 2/3
Phase 3
On Market
0
2
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.

On Market (1)

Approved therapies currently available

Baxter
PLASMA-LYTE 148 IN WATER IN PLASTIC CONTAINERApproved
sodium chloride, sodium gluconate, sodium acetate, potassium chloride and magnesium chloride
Baxter
injection1979

Competitive Landscape

7 companies ranked by most advanced pipeline stage

Baxter
BaxterCosta Rica - Cartago
2 programs
1
1
PLASMA-LYTE 148 IN WATER IN PLASTIC CONTAINER(Plasma-Lyte 148)Phase 3
Automated peritoneal dialysisN/A
Angeles Therapeutics
Angeles TherapeuticsCA - Los Angeles
2 programs
2
Conditioning and Stem cell infusionPhase 11 trial
Donor CD34+, CD3+. and belumosudilPhase 11 trial
Active Trials
NCT05525507Recruiting10Est. Dec 2026
NCT05806749Active Not Recruiting16Est. Aug 2028
Baxter International
2 programs
Automated peritoneal dialysisN/A1 trial
Plasma-Lyte 148PHASE_31 trial
Active Trials
NCT04017572Completed21Est. Sep 2020
NCT03829488Completed808Est. May 2022
Daxor
DaxorTN - Oak Ridge
1 program
Blood Volume Analysis and Related Outcomes in HemodialysisN/A1 trial
Active Trials
NCT01679249Completed10Est. May 2012
Outset Medical
Outset MedicalSAN JOSE, CA
1 program
Intermittent Renal Replacement Therapy using the Tablo Hemodialysis SystemN/A1 trial
Active Trials
NCT04912024Completed458Est. Jun 2022
Diality
DialityCA - Irvine
1 program
Moda-flx Hemodialysis System™N/A1 trial
Active Trials
NCT06613568Recruiting50Est. Sep 2027
Hansa Biopharma
Hansa BiopharmaSweden - Lund
1 program
IdeSPHASE_21 trial
Active Trials
NCT02475551Completed10Est. Oct 2016

Trial Timeline

Clinical trial activity over time

2021
2022
2023
2024
2025
2026
2027
2028
Baxter InternationalPlasma-Lyte 148
Hansa BiopharmaIdeS
Angeles TherapeuticsDonor CD34+, CD3+. and belumosudil
Angeles TherapeuticsConditioning and Stem cell infusion
DialityModa-flx Hemodialysis System™
Outset MedicalIntermittent Renal Replacement Therapy using the Tablo Hemodialysis System
Baxter InternationalAutomated peritoneal dialysis
DaxorBlood Volume Analysis and Related Outcomes in Hemodialysis

Clinical Trials (8)

Total enrollment: 1,383 patients across 8 trials

NCT03829488Baxter InternationalPlasma-Lyte 148

Better Evidence for Selecting Transplant Fluids

Start: Jan 2018Est. completion: May 2022808 patients
Phase 3Completed
NCT02475551Hansa BiopharmaIdeS

Study to Evaluate the Safety, Tolerability, Efficacy and PK of IdeS in Kidney Transplantation

Start: Jun 2015Est. completion: Oct 201610 patients
Phase 2Completed
NCT05806749Angeles TherapeuticsDonor CD34+, CD3+. and belumosudil

Immunological Tolerance in Patients With Mismatched Kidney Transplants

Start: Jul 2023Est. completion: Aug 202816 patients
Phase 1Active Not Recruiting
NCT05525507Angeles TherapeuticsConditioning and Stem cell infusion

Delayed Immunological Tolerance in Patients With Well-functioning Pre-existing HLA-matched Kidney Transplants

Start: Dec 2022Est. completion: Dec 202610 patients
Phase 1Recruiting
NCT06613568DialityModa-flx Hemodialysis System™

Moda-flx Hemodialysis System™ Under Professional Care Settings by Trained Individuals and At Home by Participants

Start: Oct 2025Est. completion: Sep 202750 patients
N/ARecruiting
NCT04912024Outset MedicalIntermittent Renal Replacement Therapy using the Tablo Hemodialysis System

Comparative Outcome Measures of Patients Receiving Acute Renal ThErapy Study

Start: May 2021Est. completion: Jun 2022458 patients
N/ACompleted
NCT04017572Baxter InternationalAutomated peritoneal dialysis

Optimized vs. Standard Automated Peritoneal Dialysis Regimens Study

Start: Jun 2019Est. completion: Sep 202021 patients
N/ACompleted
NCT01679249DaxorBlood Volume Analysis and Related Outcomes in Hemodialysis

Blood Volume Analysis and Related Outcomes in Hemodialysis

Start: Jan 2012Est. completion: May 201210 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
2 actively recruiting trials targeting 1,383 patients
7 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.