Rare Kidney Disease: Advances in Early Detection, Precision Therapies, and Clinical Practice Shifts With Swati Arora, MD

Despite the availability of biomarkers and advanced tools, early detection of rare kidney diseases remains challenging, and gaps in specialized training leave patients at risk for significant kidney damage.

Rare kidney diseases affect approximately 60 to 80 individuals per 100,000 people, encompassing > 150 distinct conditions. They represent 5% to 10% of all chronic kidney disease (CKD) cases but disproportionately contribute to kidney failure, causing > 25% of cases requiring kidney replacement therapy.

“Kidney disease is rare, which presents several challenges. During training, clinicians typically see only a small number of patients, often following them for just two years, resulting in limited longitudinal experience,” said Swati Arora, MD, FASN, an assistant professor at Drexel University, in an interview with 

. “That’s why specialized education is so important. In recent years, more global nephritis fellowships and glomerulonephritis centers have emerged to support community nephrologists and other physicians in caring for patients with rare kidney diseases.”

The treatment landscape for rare kidney diseases has shifted toward precision medicine, targeting pathways such as galactose-deficient IgA and complement activation. While these therapies offer more targeted options than traditional broad immunosuppression, clinical understanding and experience remain limited due to gaps in specialized training.

Therapeutic options for rare kidney diseases now include targeted approaches such as B-cell and plasma cell therapies, complement inhibitors, endothelin receptor antagonists, and other emerging agents. Updates to clinical guidelines in 2021 and 2025 have supported earlier patient identification and more informed, evidence-based treatment decisions.

Clinical practice is also evolving. The threshold for performing kidney biopsies has been lowered. Whereas biopsies were once recommended only for proteinuria > 1 gram per day, recent data indicate that patients with proteinuria < 500 mg/day may still progress to end-stage kidney disease within a decade. This has prompted clinicians to intervene earlier in the disease course.

Looking ahead, Arora expresses growing optimism about noninvasive biomarkers to monitor disease activity, long-term data on targeted therapies, and innovative treatments designed to prevent progression to end-stage kidney disease or the need for transplant. The management of rare kidney diseases is advancing rapidly, with an emphasis on early detection, precision medicine, and improving long-term patient outcomes.

Rare Kidney Diseases Toolkit - International Society of Nephrology. International Society of Nephrology. Published January 29, 2026. Accessed February 24, 2026. 

https://www.theisn.org/initiatives/rare-kidney-diseases-toolkit/?utm_source=Facebook&utm_medium=Organic_social&utm_campaign=Toolkits#KidneyHealth

6 New Kidney Disease Medications Approved in 2025. National Kidney Foundation. Published January 21, 2026. 

https://www.kidney.org/news-stories/6-new-kidney-disease-medications-approved-2025

Videos

Rare kidney diseases are hard to detect early, but precision therapies and updated guidelines offer new ways to improve patient outcomes.


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Diana Isaacs, PharmD, is an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic.

Novo Nordisk Gains European Approval for Semaglutide 7.2 mg, Submits Application to FDA

On February 17, 2026, the European Commission approved a semaglutide injection dose of 7.2 mg for adults living with obesity after a clinical trial displayed substantial body weight reduction on average. Additionally, parent company Novo Nordisk has submitted an application for semaglutide 7.2 mg to the US Food and Drug Administration (FDA), indicating its potential arrival in the US.

Diabetes Dialogue cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, discuss the efficacy and practicality of a 7.2 mg semaglutide formulation.

Check out the full episode on injectable GLP-1 receptor agonists 

In this segment, Isaacs and Bellini discuss recent regulatory developments involving high-dose semaglutide for obesity management, highlighting the European approval of a 7.2 mg injectable formulation. This represents a substantial increase from the current maximum 2.4 mg dose approved in the United States under Wegovy. The speakers clarify that this higher-dose formulation is indicated exclusively for chronic weight management and is distinct from Ozempic, which remains approved for glycemic control in type 2 diabetes. The distinction between obesity and diabetes indications is emphasized, particularly given ongoing public and clinical confusion surrounding semaglutide branding and dosing.

The panel notes that the 7.2 mg dose has been submitted to the FDA, with a potential approval anticipated later this year. European authorization signals that safety evaluations have been completed at this higher dose, which the speakers interpret as reassuring from a pharmacovigilance standpoint. Clinically, the higher dose appears to confer incremental weight loss beyond that achieved with 2.4 mg, potentially offering an enhanced therapeutic option for patients with overweight and obesity who require additional efficacy. The discussion frames this as part of a broader expansion of GLP-1 receptor agonist–based obesity treatment, underscoring the meaningful impact these agents have had for patients who have historically struggled with limited pharmacologic options.

Beyond efficacy, the speakers examine practical considerations related to drug delivery systems and real-world use. Current U.S. Wegovy formulations are dispensed as single-use pens designed for a defined treatment interval. It remains unclear whether the 7.2 mg formulation, if approved in the United States, would maintain this format or transition to a multi-dose, adjustable (“multi-click”) pen. This uncertainty leads to a broader caution regarding dose manipulation strategies. Some patients may attempt to extend higher-dose pens by administering smaller doses over prolonged periods to reduce costs. However, the speakers emphasize that such practices raise concerns regarding medication stability, sterility, and potency.

They note that existing semaglutide pens are typically stable at room temperature for approximately 30 days and are engineered for a limited number of injections. Extending use far beyond the intended timeframe—potentially for several months—could compromise efficacy or introduce contamination risk. While limited short-term extension may occur in practice, prolonged off-label use of a single pen is not supported by available stability data.

Overall, the conversation underscores both the therapeutic promise of higher-dose semaglutide in obesity care and the importance of adhering to approved dosing, storage, and administration guidelines as new formulations emerge.

Editor’s Note: Isaacs reports disclosures with Dexcom, Abbott, Lilly, Novo Nordisk, Medtronic, Insulet, and others. Bellini reports disclosures with Abbott Diabetes Care, MannKind, Povention Bio, and others.

Novo Nordisk. Novo Nordisk A/S: The European Commission approves more effective dose of injectable Wegovy for adults with obesity; clinical study showed people lost about 21% of their body weight on average. 

. February 17, 2026. Accessed February 24, 2026. 

https://www.biospace.com/press-releases/novo-nordisk-a-s-the-european-commission-approves-more-effective-dose-of-injectable-wegovy-for-adults-with-obesity-clinical-study-showed-people-lost-about-21-of-their-body-weight-on-average

Diabetes Dialogue cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, cover the recent approval and what it means for Wegovy 7.2 mg in the US.

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Diabetes Dialogue

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Strategic Alliance Partnership

Susan Taylor, MD, a professor and vice chair for Diversity, Equity, and Inclusion at the Perelman School of Medicine. 

Nada Elbuluk, MD, MSc, is a dermatologist in California. 

Skin of Color Savvy: The Art and Science of Treating Patients of Color

Skin of Color Savvy: Why 2026 Is the Year of Skin Equity, With Susan Taylor, MD, Nada Elbuluk, MD, MSc, and Mona Shahriari, MD

episode, hosted by Skin of Color Society (SOCS) leaders and produced by 

, Mona Shahriari, MD, assistant clinical professor of dermatology at the Yale School of Medicine and host of 

, led a forward-looking conversation on advancing 

 equity with Susan Taylor, MD, the Bernett Johnson Endowed Professor of Dermatology at the University of Pennsylvania Perelman School of Medicine, and Nada Elbuluk, MD, MSc, board-certified dermatologist and Professor at the USC Keck School of Medicine, Department of Dermatology.

Framing 2026 as a potential “pivotal year,” Shahriari guided a discussion that moved beyond awareness of disparities toward measurable action. Taylor reflected on how the current moment differs from the past, citing tangible therapeutic advances in conditions that disproportionately affect patients with skin of color, including hidradenitis suppurativa (HS) and atopic dermatitis. She also pointed to growing educational resources—such as expanded image libraries, textbooks, and conference programming—as evidence that skin of color dermatology is no longer confined to side conversations but embedded in mainstream discourse.

Elbuluk emphasized accountability as a defining shift. Industry, journals, and conference organizers are increasingly expected to demonstrate meaningful inclusion in research, imagery, and programming. However, both she and Taylor stressed that progress remains incomplete, particularly in clinical trial representation. They highlighted the importance of diversifying trial sites, training more investigators from underrepresented backgrounds, and intentionally designing studies that capture endpoints relevant to diverse patient populations—including pigmentary sequelae and disease burden nuances.

Education was another focal point. Elbuluk underscored the need for standardized residency training in skin of color dermatology, while Taylor highlighted continuing medical education and integrated conference sessions that compare presentations across skin tones. Both reinforced that competency in treating diverse populations is no longer optional in an increasingly heterogeneous US patient base.

The discussion also addressed advocacy, including collaborative efforts to address policy issues such as pseudofolliculitis barbae in military service members. Looking ahead to emerging technologies, Elbuluk cautioned that artificial intelligence (AI) tools must be built on diverse datasets to avoid perpetuating bias, while Taylor stressed the importance of dermatologists occupying decision-making rooms and spaces.

In closing, the speakers urged grassroots action—whether by deepening knowledge in unfamiliar disease states, joining advocacy committees, or simply reaching out to colleagues for guidance. As Elbuluk noted, progress requires sustained momentum, and as Taylor emphasized, achieving equity will depend on collective effort across the dermatology community.

To learn more about SOCS’s programs and initiatives, visit 

Editor’s note: This summary was edited with the help of AI tools.

This new February episode of the Skin of Color Savvy podcast highlights why 2026 may be the year of skin health equity in the dermatology field.

Hosted by Skin of Color Society and produced by HCPLive, 

 delves into the latest research, clinical insights, and culturally intelligent care practices in dermatology with leading experts. 

Whether it’s groundbreaking research, practice-changing insights, or highlights from the SOCS community, this twice-monthly program provides dermatologists and care providers with expert perspectives on treating patients with skin of color.

Dermatology

The HCPLive dermatology page is a resource for medical news and expert insights on skin disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for dermatologic conditions, and more.

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Julia W. Angkeow, a PhD candidate and former research technologist at Johns Hopkins Medicine

Early-Life IgG Patterns Linked to Childhood Food Allergy, With Julia Angkeow

 in early childhood, but not observed at birth.

, investigator Julia W. Angkeow, a PhD candidate and former research technologist at Johns Hopkins Medicine, emphasized that the study was intended not to validate IgG as a diagnostic tool, but to map the broader IgG reactome in an unbiased way.

Using Phage ImmunoPrecipitation Sequencing (PhIP-Seq), a high-throughput antibody profiling platform developed in their laboratory, Angkeow and colleagues analyzed IgG responses to hundreds of thousands of peptides derived from allergens, viruses, toxins, and human proteins.

“It gives us a broad picture of what someone has been exposed to in their environment and how their immune system has responded to their past and ongoing immune exposures,” Angkeow told 

. “What we found through this study is that we can use PhIP-Seq to identify IgG patterns that are distinct between allergic and allergic children, and they're also distinct in early childhood versus at birth.”

The prospective cohort included 458 children: 80 with food allergy, 151 with food sensitization, and 227 non-allergic controls without other atopic disease.1 Investigators profiled matched cord blood and early-childhood plasma samples. In early childhood, but not in cord blood, children with food allergy exhibited significantly greater diversity of IgG reactivity to allergen peptides (false discovery rate < 0.05).

Peanut-allergic children demonstrated greater IgG reactivity to 24 peanut peptides, while egg-allergic children showed increased responses to 17 egg peptides. Angkeow cautioned clinicians against overinterpreting these findings. She noted that elevated IgG likely reflects ongoing or repeated immune exposure and should not be interpreted as protective, pathogenic, or diagnostic. Professional societies have previously advised against IgG-based food sensitivity testing due to lack of clinical validity.2

One unexpected finding was lower cord blood IgG reactivity to milk peptides among children who later developed milk allergy. While this observation is consistent with the hypothesis that maternally transferred allergen-specific IgG could be protective, Angkeow emphasized that the study measured total IgG and did not distinguish subclasses with differing immunologic functions.

“There needs to be more mechanistic studies, such as profiling different IgG subclasses to test that directly,” she said.

Angkeow JW, Hong X, Thakar M, et al. Diverse food allergen IgG reactivities are associated with food allergies in the Boston Birth Cohort. 

https://pubmed.ncbi.nlm.nih.gov/41689198/

McGill University. Office for Science and Society. Published August 30, 2024. Accessed February 24, 2026. 

https://www.mcgill.ca/oss/article/medical-critical-thinking-health-and-nutrition/no-tolerance-igg-food-intolerance-tests

Allergy

Allergy condition center page is a comprehensive resource for clinical news and insights on allergic and inflammatory diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for food and seasonal allergies, as well as allergic asthma and related conditions.

Food Allergy

Eli Lilly Launches Zepbound KwikPen Multi-Dose Tirzepatide Pen for Adults With Obesity

On February 23, 2026, Eli Lilly announced the commercial release of the Zepbound KwikPen, a single-patient injectable pen containing a full month’s dose of tirzepatide for patients with obesity. The pen – and its disposable needles – are already available at LillyDirect Pharmacy.

Diabetes Dialogue cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, discuss the promise of this new, easier-to-use pen, and its implications for the future of weight loss therapies.

Check out the full episode on the KwikPen’s release 

In this discussion, Isaacs and Bellini review the launch of Zepbound in a new single-pen, multi-dose KwikPen format, now available through Lilly Direct, and explore its clinical, practical, and environmental implications. Unlike the previous packaging—four single-use, fixed-dose pens per month—the KwikPen consolidates a full month of therapy into one reusable device, aligning more closely with insulin pen delivery systems familiar to clinicians and patients.

A major focus of the conversation is dose flexibility and tolerability. The speakers reflect on prior experience with GLP-1 receptor agonists such as Ozempic, where patients often experience gastrointestinal adverse effects during dose escalation. While the labeled starting dose (2.5 mg) is not considered therapeutic, some patients still struggle with tolerability. The KwikPen format may allow clinicians to make smaller incremental adjustments between approved dose levels, facilitating slower titration strategies in select patients. Although such approaches would be off-label, they reflect common real-world practice aimed at improving adherence and long-term persistence. In contrast, vial-based administration—despite theoretical flexibility—has not supported incremental dosing due to the absence of preservatives and the increased infection risk associated with repeated syringe entry.

The speakers also emphasize workflow and patient-experience advantages. Pens are generally preferred over vials in contemporary diabetes care, consistent with guideline recommendations in insulin therapy. The KwikPen reduces device burden for patients, particularly during travel, as one pen replaces four disposable devices per month. Environmental considerations are also highlighted: transitioning from four disposable pens to one reusable pen per month meaningfully decreases medical waste and landfill contribution.

Operational details are addressed for prescribers. The KwikPen does not include pen needles, requiring a separate prescription or over-the-counter purchase. The speakers recommend 4- or 5-mm pen needles for most patients and caution against longer lengths. Additionally, unlike Ozempic—which requires priming only once upon first use—the Zepbound KwikPen should be primed prior to each injection, similar to insulin pens. This distinction is clinically relevant for patient education.

Importantly, all dose strengths, including higher maintenance doses (e.g., 15 mg), are available at launch. This allows patients currently receiving vial formulations to transition immediately without dose disruption. The speakers conclude that the KwikPen represents a meaningful advancement in convenience, tolerability management, and sustainability, while underscoring the importance of prescriber familiarity with its distinct administration requirements.

1: Eli Lilly. Zepbound (tirzepatide), the most prescribed weight management medication in 2025, now available in multi-dose KwikPen. February 23, 2026. Accessed February 24, 2026. 

https://investor.lilly.com/news-releases/news-release-details/zepbound-tirzepatide-most-prescribed-weight-management

Diabetes Dialogue cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, discuss Lilly’s groundbreaking new Zepbound administration option.

Chelsie Derman is an associate editor for 

who covers psychiatry, sleep medicine, geriatrics, migraine, and allergy. She joined MJH Life Sciences in September 2023 after graduating from The College of New Jersey with a bachelor’s degree in journalism and professional writing. In her free time, she enjoys creative writing and reading.

Articles

FDA approves dupilumab for allergic fungal rhinosinusitis, supported by phase 3 LIBERTY-AFRS-AIMS data showing reduced symptoms and corticosteroid or surgery use.

FDA News

FDA Approves Dupilumab for AFRS in Patients Aged ≥ 6 Years With Prior Surgery

HCPLive speaks with Mark Lebwohl, MD, about recent data on those with psoriasis and obesity or overweight treated with ixekizumab (Taltz) and tirzepatide (Zepbound).

Plaque Psoriasis

The HCPLive plaque psoriasis page is a resource for medical news and expert insights on psoriasis. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for psoriatic disease, and more.

Discussing New Data on Ixekizumab, Tirzepatide for Psoriasis and Weight Loss, With Mark Lebwohl, MD

Ryan Livingston joined the MJH Life Sciences team in March of 2025, shortly after graduating from TCNJ with a bachelor’s degree in English. He enjoys creative writing, reading, and scuba diving. He can be reached at rlivingston@mjhlifesciences.com.

The list price of all 3 semaglutide drugs will be lowered to $675, marking a reduction of roughly 50% and 35% for Wegovy and Ozempic, respectively.

Type 2 Diabetes

Novo Nordisk Announces 2027 Price Reduction of Wegovy, Ozempic, Rybelsus

Abigail Brooks is an assistant managing editor for 

She joined MJH Life Sciences in August 2023 shortly after graduating from Monmouth University where she earned her BA in Communication with a concentration in Public Relations/Journalism and later an MA in Interactive Digital Media. She enjoys traveling, running, and reading books. She can be reached at abrooks@mjhlifesciences.com.

In a phase 2 trial in Chinese people with overweight or obesity, UBT251 led to mean weight loss of up to 19.7% (-17.5 kg) after 24 weeks.

UBT251, A Triple Agonist, Delivers Up To 19.7% Mean Weight Loss in Phase 2 Trial

Dr Cristancho addresses how regulatory constraints and educational gaps affect real-world use of non-incretin agents and highlights the need for practical, guidance-based training.

Regulatory considerations and clinician education for non-incretin obesity therapies

Dr Cristancho explains how to sequence or switch among non-incretin agents and how to reframe pharmacotherapy as part of long-term, chronic disease management rather than short-term weight loss.

Sequencing non-incretin agents and framing obesity as a chronic disease

Diabetes Dialogue cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, discuss the Portal Pump's recent Breakthrough Designation from the FDA.

Implantable Portal Insulin Pump Receives FDA Breakthrough Designation

Mauro Cancian, MD, PhD, head of the allergy division at the University of Padua.

KONFIDENT investigator Cancian discusses oral sebetralstat’s role in the updated HAE treatment guidelines.

HAE Guidelines Reinforce Early On-Demand Treatment, With Mauro Cancian, MD, PhD

Victoria Johnson joined the MJH Life Sciences in 2020 and has written for NeurologyLive, CGTLive, and now HCPLive. You can reach her at vjohnson@mjhlifesciences.com

An audio recap of the top 5 stories in healthcare news from the week of 02/15-02/21.

Cardiology

Cardiology condition center page is a comprehensive resource for clinical news and insights on cardiovascular and cardiometabolic diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for heart disease and cardiovascular events, as well as associated diabetes, renal failure, and more...

MASH / MASLD

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Hepatology

HCPLive 5 Stories in Under 5: Week of 02/15

Mary K Roberts, PhD is a Post Doctoral Researcher at the Leverhulme Centre for Demographic Science at the University of Oxford.

Survey of 600 US relatives finds donor–recipient closeness and expected life extension drive living kidney donation more than financial concerns.

Latest News

Rare Kidney Disease: Advances in Early Detection, Precision Therapies, and Clinical Practice Shifts With Swati Arora, MD

Novo Nordisk Gains European Approval for Semaglutide 7.2 mg, Submits Application to FDA

Skin of Color Savvy: Why 2026 Is the Year of Skin Equity, With Susan Taylor, MD, Nada Elbuluk, MD, MSc, and Mona Shahriari, MD

Early-Life IgG Patterns Linked to Childhood Food Allergy, With Julia Angkeow

Eli Lilly Launches Zepbound KwikPen Multi-Dose Tirzepatide Pen for Adults With Obesity