Could a common diabetes drug protect the hearts of kidney patients?

People with chronic kidney disease (CKD) often have an overactive sympathetic nervous system, which raises their risk of heart problems and death. This phase 4 trial tests whether pioglitazone, a drug usually used for diabetes, can reduce that nerve overactivity and improve blood vessel function. The study enrolls adults aged 35 to 70 with moderate-to-severe CKD (stages 3 and 4). Participants receive either pioglitazone or a placebo daily for one month, and researchers measure nerve activity directly using a tiny electrode inserted near the knee.