# Baxdrostat lowered systolic BP by 8.1 mm Hg versus placebo in a phase 2 trial in chronic kidney disease

- Published: 2026-11-10 16:51 UTC
- Section: Life & Health › Medicine
- Tags: baxdrostat, aldosterone synthase inhibitor, chronic kidney disease, uncontrolled hypertension, systolic blood pressure, phase 2 trial, hyperkalemia, type 2 diabetes
- URL: https://realtech.media/news/rt-85cc0a2690c1d1f667e585c3_baxdrostat_lowered_systolic/

**In a phase 2 trial of 195 adults with chronic kidney disease and uncontrolled hypertension, the aldosterone synthase inhibitor lowered systolic pressure; hyperkalemia was more frequent.**

![Baxdrostat lowered systolic BP by 8.1 mm Hg versus placebo in a phase 2 trial in chronic kidney disease](https://realtech.media/media/2026/11/b33784404822b7a5.jpg)
*CNEcija12345, Wikimedia Commons, CC BY-SA 4.0*

A phase 2 trial of baxdrostat, an aldosterone synthase inhibitor, in people with chronic kidney disease (CKD) and uncontrolled hypertension was published in the Journal of the American Society of Nephrology. Between April 29, 2022, and May 2, 2024, 195 participants were randomized. At week 26, the placebo-corrected reduction in systolic blood pressure in the pooled baxdrostat group was 8.1 mm Hg (95% CI, –13.4 to –2.8; P = 0.003) [1].

Aldosterone raises blood pressure and contributes to CKD progression, which is the rationale for the approach, according to the authors [1].

## Trial design and participants

The trial was randomized, double-blind, placebo-controlled and multicenter. Participants were taking an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Their mean seated office systolic pressure was at least 140 mm Hg without diabetes or at least 130 mm Hg with type 2 diabetes, and the urine albumin-creatinine ratio was at least 100 mg/g [1].

Participants were assigned 1:1:1 to a low dose (0.5 mg up-titrated to 1 mg), a high dose (2 mg up-titrated to 4 mg) or placebo for 26 weeks. The primary end point was the change in mean seated office systolic pressure from baseline in the pooled baxdrostat group versus placebo [1].

The mean age was 66 years (SD 11), 32% were women and 80% had type 2 diabetes. Mean baseline systolic pressure was 151.2 mm Hg (SD 13.1), mean eGFR was 44 ml/min per 1.73 m² (SD 14), and the median urine albumin-creatinine ratio was 714 mg/g [1].

## Blood pressure and safety results

The placebo-corrected change in systolic pressure was –9.0 mm Hg (95% CI, –15.1 to –2.9; P = 0.004) in the low-dose group and –7.2 mm Hg (95% CI, –13.2 to –1.2; P = 0.02) in the high-dose group [1].

Hyperkalemia was the most frequent treatment-emergent adverse event. It was recorded in 41% (53 of 128) of participants in the pooled baxdrostat group and in 5% (3 of 64) in the placebo group. The authors reported that baxdrostat was well tolerated [1].

The study lasted 26 weeks and measured blood pressure and safety over that period. The authors concluded that baxdrostat reduced systolic pressure in this population and that hyperkalemia was reported more often with the drug than with placebo [1].

## Sources

1. [Journal of the American Society of Nephrology](https://doi.org/10.1681/ASN.0000000849)
2. [knowridge.com](https://knowridge.com/2026/11/a-drug-lowered-stubborn-blood-pressure-in-people-with-kidney-disease)

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Source: RealTech, realtech.media — https://realtech.media/news/rt-85cc0a2690c1d1f667e585c3_baxdrostat_lowered_systolic/