Akebia Therapeutics, Inc.

Q1 2026 total revenue was $53.5 million versus $57.3 million in Q1 2025. Vafseo net product revenue was $15.8 million versus $12 million, a 32% increase, while Auryxia net product revenue was $36.2 million versus $43.8 million. Cost of goods sold was $12.3 million versus $7.6 million; R&D was $14.8 million versus $9.8 million; SG&A was $30.4 million versus $25.7 million. Net loss was $9.1 million versus net income of $6.1 million. Cash and cash equivalents were $162.6 million at March 31, 2026, down from $184.8 million at December 31, 2025. Management said existing cash resources and cash from operations should fund the current operating plan for at least 2 years. On outlook, management said Auryxia revenue should decline in 2026 versus 2025 due to generic competition, while Vafseo growth should continue as more dialysis organizations adopt observed dosing and as DaVita is expected to move to observed dosing in the second half of the year.

John Butler framed the quarter as a strong start to 2026 and emphasized three priorities: growing Vafseo, building evidence to support it as standard of care, and advancing the kidney disease pipeline. He said the company is seeing progress across dialysis organizations, with observed dosing improving adherence and access, and argued that the recent clinical publications strengthen the case for Vafseo. His tone was optimistic but grounded, repeatedly pointing to “lots of room to grow” rather than giving precise timing for acceleration.

Erik Ostrowski said the quarter showed Vafseo revenue growth but also continued pressure from Auryxia. He quantified the main drivers: total revenue of $53.5 million, Vafseo revenue of $15.8 million, Auryxia revenue of $36.2 million, and a net loss of $9.1 million; he also noted higher COGS from inventory write-downs, particularly on Auryxia. He said cash was $162.6 million and reiterated that the company expects cash plus operating cash flow to cover at least two years, while also flagging that Auryxia revenues should decline in 2026 because of generic competition.

Analysts focused on whether March’s Vafseo patient surge carried into April, which dialysis providers were driving uptake, and whether DaVita’s eventual move to observed dosing could change the growth curve. Management said the growth was broad-based across dialysis organizations, with USRC, IRC and DCI showing strong momentum and DaVita growing more slowly but expected to shift in the second half of the year. On FSGS, they said Filspari’s approval should not materially hurt enrollment because the bigger challenge is competition for patients, and they added that a clinically meaningful praliciguat result would be roughly a 20% improvement in UPCR change and, importantly, a meaningful share of patients reaching UPCR below 0.7 grams per gram.