Prokidney Corp. · NASDAQ:PROK
Prokidney — Corporate Update (October 2026)
55 slides from Prokidney's corporate update, Oct 27, 2026
Slide 1: ASN Kidney Week Recap & Corporate Update
American Society of Nephrology (ASN) Kidney Week Recap & Corporate Update October 27, 2026 NASDAQ PROK Copyright © 2026 ProKidney Corp. All rights reserved.
Slide 2: Forward-looking Statements
Forward-looking Statements This presentation includes “forward-looking statements” within the meaning of the “safe harbor” provisions of the Private Securities Litigation Reform Act of 1995. ProKidney’s actual results may differ from its expectations, estimates and projections and consequently, you
Slide 3: Today's Agenda and Speakers
Today’s Agenda and Speakers Bruce Culleton, MD, CEO Anthony Conway, PhD, Head of R&D Katherine Tuttle, MD, KOL The Quest to Save Kidneys, Hearts, 1 Opening Remarks & Corporate Update 3 and Lives: Mechanisms Matter 2 Rilparencel MoA Findings 4 Q&A MoA = Mechanism of Action KOL = Key Opinion Leader 3
Slide 4: Opening Remarks & Corporate Update
BRUCE CULLETON, MD, CEO Opening Remarks & Corporate Update
Slide 5: Redefining What's Possible in the Treatment of CKD Through Innovation and Execution
Redefining What's Possible in the Treatment of CKD Through Innovation and Execution Rilparencel Potential first-in-class autologous cell therapy designed to preserve kidney function in patients with advanced CKD Phase 3 PROACT 1 trial in patients with Stage ONGOING (Q2 2027 readout) Pivotal Phase 3
Slide 6: Anticipated Upcoming Milestones
Anticipated Upcoming Milestones Timing Milestones Complete full enrollment for the Phase 3 PROACT 1 study. Anticipate enrolling over 500 patients (up from Q1 2027 470) driven by an acceleration in patient recruitment in mid-2026. Topline readout for the Phase 3 PROACT 1 surrogate endpoint (eGFR slop
Slide 7: Rilparencel Phase 3 Registrational Study Design
PHASE 3 REGEN-006 (PROACT 1) Rilparencel Phase 3 Registrational Study Design Topline results for the eGFR slope surrogate endpoint anticipated in Q2 2027 1st 2nd Rilparencel Rilparencel Rilparencel Cohort Biopsy Injection Injection n>500 End of Study (EOS) 3 3 3 months months months Screening R Sham
Slide 8: Rilparencel Mechanism of Action (MoA) Findings
A N T H O N Y C O N W A Y, P h D , H E A D O F R & D Rilparencel Mechanism of Action (MoA) Findings
Slide 9: Rilparencel: A patient's own cells, from biopsy to kidney therapy
Rilparencel: A patient's own cells, from biopsy to kidney therapy Process overview Rilparencel: Kidney cells x Then frozen for are isolated preservation & • Made from patient’s own kidney cells & expanded shipping to site 22 33 • No genetic modification • No preconditioning • No lifelong immunosuppr
Slide 10: Utilizing translational disease models to elucidate rilparencel MoA
Utilizing translational disease models to elucidate rilparencel MoA In vitro Ex vivo In vivo (rodent) In vivo (human decedent) Primary kidney cells Kidney biopsy explant culture Rodent models of CKD CKD donor Control Rilparencel Kidney-on-chip Advantages • Quick: Fast design-test-learn cycles • Nati
Slide 11: Identifying the cellular origin of rilparencel from kidney biopsies
Identifying the cellular origin of rilparencel from kidney biopsies Biopsy Early Passage Late Manufacturing / Rilparencel scRNA-seq 3 CKD donor kidneys LM Stage 4 CKD Stage 2 Biopsy CKD Early Late Stage 5 CKD For the purpose of this presentation, rilparencel may refer to selected renal cells (SRC),
Slide 12: Cellular trajectory from biopsy to rilparencel
Cellular trajectory from biopsy to rilparencel Nephron (functional unit of kidney) CNT IC TAL PT INT EC & Immune Cortex Medulla Dimension 1 (UMAP1) Cell cycle phase Biopsy Early stage Late stage Rilparencel Actively Temporal inferred transition dividing Late-stage expression similarity cells Dimensi
Slide 13: Distinct lineage-associated populations in rilparencel across 17 patient batches
2 distinct lineage-associated populations in rilparencel present in 17 patient batches Population Markers scRNA-Seq Unbiased Clustering Proximal & Distal Population Clusters Dimension 1 (UMAP1) Dimension 1 (UMAP1) Dimension 2 (UMAP2) Dimension 2 (UMAP2) Proximal Distal Lineage-associated rilparencel
Slide 14: Similar characterization marker expression across rilparencel batches
Similar characterization marker expression across 17 rilparencel batches Rilparencel Characterization Panel (scRNA-Seq) Examples of Expression Trajectory from Biopsy to Rilparencel VEGFA MGST1 Rilparencel Biopsy Early Late Cells of proximal & distal tubule origin exhibiting a reparative, plasticity-
Slide 15: Utilizing in vitro CKD models to assess resolution of disease state
Utilizing in vitro CKD models to assess resolution of disease state by rilparencel Activation of Disease Rilparencel Resolution of Disease Kidney-on-chip State Phenotype Treatment State Phenotype Primary kidney cells v Workstream Goals • Develop advanced, human-relevant in vitro disease models for r
Slide 16: In vitro functional assays measure common CKD pathway-relevant readouts
In vitro functional assays measure common CKD pathway-relevant readouts CKD Inducers & Drivers Hyperglycemia Hyperlipidemia Hypoxia Common CKD Pathways Oxidative stress Metabolic dysregulation Cell death Inflammation Fibrosis Tuttle et al. Kidney International (2022) Functional Assay Testing Deconvo
Slide 17: Rilparencel co-culture in injured kidney-on-chip experimental design
Rilparencel co-culture in injured kidney-on-chip experimental design Kidney-on-chip Nephron (MIMETAS OrganoPlate) (functional unit of kidney) Key Considerations • Model captures endothelial : epithelial ECM Blood Vessels interface & crosstalk • Rilparencel is administered directly on ECM GMVEC RPTEC
Slide 18: Rilparencel promotes endothelial junctional & barrier integrity
Rilparencel promotes endothelial junctional & barrier integrity 3D Mechanistic Discovery 3D & 2D Functional Validation CD31 VE-Cadherin Barrier Permeability 10000 2000 a a b 8000 b 1.5×10 -5 1500 c 6000 c 1000 a 4000 Papp (cm/s) 2000 500 1×10 -5 0 0 b ol C ry ol C ry R R tr tr ju ju 5×10 -6 c +S +S
Slide 19: Rilparencel promotes native endothelial metabolic state
Rilparencel promotes native endothelial metabolic state Basal Respiration Spare Respiratory Capacity 30 40 Control (pmol/min/1x103 cells) (pmol/min/1x103 cells) 30 IM v2.0 20 IM v2.0 + PK014 Rilparencel-treated (2 donor batches) OCR OCR 20 IM v2.0 + PK025 10 10 0 0 1 4 1 4 Days Post-Treatment Days P
Slide 20: Rilparencel attenuates pro-inflammatory signaling & recruitment cues
Rilparencel attenuates pro-inflammatory signaling & recruitment cues Kidney-on-chip 3D in vitro testing platform (DAMP secretion assay) 2D In vitro testing platform (ELISA) Endothelial Compartment 60 IκBα NFκB Injury Rilparencel Fold Change over Control HMBG-1 : LDH Ratio ns ns Control 40 ✱ ✱ ✱ ✱ In
Slide 21: Rilparencel lowers reactive iron species & activates lipid peroxidation repair
Rilparencel lowers reactive iron species & activates a cytoprotective lipid peroxidation repair program in injured renal epithelial cells Total Iron Fe3+/Fe2+ Ratio Iron Fractions 50 15 60 Iron (μM/μg protein) Iron (μM/μg protein) a Ferric (Fe3+) 40 b b a Ferrous (Fe2+) Fe3+ : Fe2+ 10 40 30 20 b 5 2
Slide 22: Rilparencel rescues oxidative damage & mitochondrial dysfunction
Rilparencel rescues oxidative damage & mitochondrial dysfunction in continuously injured renal epithelial cells Control Injury Injury + SRC Coupling Efficiency Spare Capacity Bioenergetic Health 6 15 #^ #^ # 120 BHI (% of control) Cellular RCRbasal Cellular RCRmax #^ #^ #^ #^ #^ # 100 4 10 80 60 2 *
Slide 23: GPX4 activity is required for rilparencel-mediated rescue
GPX4 activity is required for rilparencel-mediated rescue of oxidative damage & mitochondrial dysfunction in epithelial cells Total Glutathione Glutathione Redox Balance 5×10 4 2.5 a (normalized to cell count) ab a 4×10 4 ab 2.0 ab a a (total/oxidized) b GSH/GSSG 3×10 4 1.5 b RLU c c c 2×10 4 1.0 1×
Slide 24: Factors expressed by rilparencel with potential mechanistic relevance
Rilparencel Factors expressed by rilparencel with potential mechanistic relevance Upregulation of Increased expression of chemotactic, protective paracrine & cytoprotective, & stress- microenvironmental adaptation factors regulators Downregulation of baseline prostaglandin catabolism, amino acid met
Slide 25: Designing a multiomic approach to probe MoA in rodent CKD models
Designing a multiomic approach to probe MoA in rodent CKD models • Preclinical proof-of-concept: Intracortically administered syngeneic selected renal cells (SRC) extended survival & stabilized renal function (sCR, BUN) in rodent (Kelley et al., 2010) & dog CKD models, improved survival & stabilized
Slide 26: Rilparencel distributes to subcapsular & intraparenchymal renal compartments
Rilparencel distributes to subcapsular & intraparenchymal renal compartments, partially persists through Day 28 Humanized NSG-IL15 mice fed adenine 1-day post-dose 28 days post-dose hKu80+ hmCD45- = Rilparencel hKu80+ hmCD45+ = Human immune cells hKu80- hmCD45+ = Mouse immune cells Vascular smooth m
Slide 27: Aligning multiomic analytical modalities after rilparencel injection
Aligning multiomic analytical modalities after rilparencel injection IHC Spatial transcriptomics Human nuclei (rilparencel) Rilparencel-associated gene All nuclei 27
Slide 28: Graft-associated cells have a distinct transcriptional signature in injected rats
Graft-associated cells have a distinct transcriptional signature in injected rats • Significantly upregulated genes in graft area cells 3 days post-rilparencel are associated with ECM remodeling & vascular development, including matrix organization & turnover, collagen biosynthesis, & blood vessel m
Slide 29: Transcriptional signature of graft-associated cells evolves over time
Transcriptional signature of graft-associated cells evolves over time Days post-rilparencel injection • The injured kidney’s response to rilparencel is dynamic & evolves over time • An initial higher upregulation in ECM remodeling gene expression drops over the first week after treatment but is main
Slide 30: Aligning multiomic analytical modalities after rilparencel injection
Aligning multiomic analytical modalities after rilparencel injection Single nuclei RNA-seq Rilparencel-treated Vehicle-treated Healthy Control IHC Spatial transcriptomics Human nuclei (rilparencel) Rilparencel-associated gene All Nuclei 30
Slide 31: Cell junction & ECM adhesion signaling upregulated in rat kidney endothelial cells
Cell junction & ECM adhesion signaling is upregulated in rat kidney endothelial cells Endothelial junction & Endothelial adhesion & • Kidney snRNA-seq at 28 days post-dose in RNU rats with ECM programs stability programs adenine-induced CKD; endothelial nuclei identified using rodent kidney cell atl
Slide 32: Aligning multiomic analytical modalities after rilparencel injection
Aligning multiomic analytical modalities after rilparencel injection Single nuclei RNA-seq Rilparencel-treated Vehicle-treated Healthy Control IHC Spatial Transcriptomics Human nuclei (rilparencel) Rilparencel-associated gene Mass spec imaging (MSI) All Nuclei PI O-32:0 PE 40:3 32
Slide 33: MSI reveals a distinct tissue remodeling signature at the injection site
MSI reveals a distinct tissue remodeling signature at the rilparencel injection site Signature domains hKu80 (rilparencel) • MSI spatially resolved protein & lipid biomarkers within an injection-defined ROI encompassing the hKu80-associated rilparencel injection site at day 3 post-injection • ROI sh
Slide 34: Translational studies suggest multifactorial MoA for rilparencel
Translational studies suggest multifactorial MoA for rilparencel How rilparencel may Human proximal tubule epithelial cell & glomerular vascular be able to preserve Primary kidney cells endothelial cell models of metabolic & inflammatory stress cultured with rilparencel showed (ASN poster TH-PO1128)
Slide 35: The Quest to Save Kidneys, Hearts, and Lives: Mechanisms Matter
The Quest to Save Kidneys, Hearts, and Lives Mechanisms Matter Katherine R. Tuttle, MD, FASN, FACP, FNKF Executive Director for Research Providence Inland Northwest Health Professor of Medicine Nephrology Division and Kidney Research Institute University of Washington School of Medicine In the spiri
Slide 36: CKD Is A Global Public Health Crisis
CKD Is A Global Public Health Crisis Western Europe USA 44 MILLION Worldwide Extremely common Increasing 850 death rate 40 MILLION MILLION 2017- 41.5% from 1990 to 2017 and in 2023 2023 caused 5th 144,000 1 in10 9th 13th 147,000 in 2023 19th deaths 2040 people in the general 2013 2016 2019-2025 (pre
Slide 37: What Problem are We Trying to Solve?
What Problem are We Trying to Solve? 589 million 2024 and 850 million 2050 Tuttle KR et al. CJASN 2022;17:1092-1103 International Diabetes Federation Atlas 11th edition, 2025
Slide 38: Cardiovascular-Kidney-Metabolic Syndrome: Kidney in the Middle
Cardiovascular-Kidney-Metabolic Syndrome Kidney in the Middle Tuttle KR et al. Clin J Am Soc Nephrol 2026; online ahead of print Ndumele CE et al. Circulation 2023; 148:1636-1664
Slide 39: Goal: Mitigate High Kidney & Cardiovascular Risk
GOAL: MITIGATE HIGH KIDNEY & CARDIOVASCULAR RISK Grams ME et al. JAMA 2023;330:1266-1277.
Slide 40: Combination Therapy and the 4-Pillars
Combination Therapy and the 4-Pillars Diabetic and Non-Diabetic CKD Neuen B et al. Nephrol Dial Transplant 2025:40 (S1):i59-i69
Slide 41: Complementary Mechanisms for CKM Therapies
Complementary Mechanisms for CKM Therapies Alicic RZ, Neumiller JJ, Tuttle KR. Nephrol Dial Transplant 2025; 40 (S1):i3–i17
Slide 42: Combination Therapy and Kidney Outcomes
Combination Therapy and Kidney Outcomes Added to RAS Blockade Neuen BL et al. Circulation 2024;149:450–462
Slide 43: Combination Therapy and Cardiovascular Outcomes
Combination Therapy and Cardiovascular Outcomes Added to RAS Blockade Neuen BL et al. Circulation 2024;149:450–462
Slide 44: Time to Events for Survival and Kidney Function in CKD
Time to Events for Survival and Kidney Function in CKD Population Level and Person Level Tuttle KR et al. Clin J Am Soc Nephrol 2026; online ahead of print
Slide 45: Residual Risks with Current CKD Therapies
Residual Risks with Current CKD Therapies Questions and Potential Roles for Rilparencel • Who are treatment responders and non-responders? • TBD • What therapy or combination will work best? • TBD • When is the right time to deploy therapy? • Rilparencel as a reparative tool • Why does a therapy wor
Slide 46: What Can We Learn from Mechanistic Studies?
What Can We Learn from Mechanistic Studies?
Slide 47: Reduced Albuminuria and Stabilized eGFR
Reduced Albuminuria and Stabilized eGFR Semaglutide treatment compared to placebo UACR Change in eGFR after 52 weeks: Creatinine-cystatin C-based Change from baseline (mL/min/1.73 m ) 2.0 2 • UACR reduced 40% 4 (ETR 0.60, 95% CI 0.41;0.88, p=0.008) 1.5 Ratio to baseline 2 • eGFR differences • Creati
Slide 48: Reduced Kidney Fat and Renal Arterial Resistance with Stabilized Cortical Fibrosis
Reduced Kidney Fat and Renal Arterial Resistance with Stabilized Cortical Fibrosis Kidney fat Renal arterial resistive index Cortical ADC Semaglutide treatment compared to placebo 1.75 1.06 1.10 Perirenal Sinus ETR 0.96 [95% CI 0.93;0.99] after 52 weeks: ETR 0.75 ETR 0.87 p = 0.008 [95% CI 0.58;0.97
Slide 49: Indicators of Improved Glomerular Filtration and Barrier Function
Indicators of Improved Glomerular Filtration and Barrier Function Creatinine clearance Filtration fraction 16 1.50 ETD 12.0 (95% CI 0.7;23.3) p = 0.038 Change from baseline (m L/min) 12 Semaglutide treatment compared ETR 1.19 [95% CI 0.98;1.45] to placebo after 52 weeks: 8 3.0 p = 0.086 Ratio to bas
Slide 50: Transcriptomic Reprogramming in Glomerular Endothelial Cells
Transcriptomic Reprogramming in Glomerular Endothelial Cells Glom erular endothelial cells 1 Glom erular endothelial cells 2 Regulation Natural killer T cell Down Proxim al tubule cells 2 Up Connecting nephron Connecting nephron - im m une UMAP dimension 2 -75 75 -50 50 -25 25 0 25 50 75 Num ber of
Slide 51: Ligand-Receptor Interactions between Glomerular Endothelial Cells and Immune Cells
Ligand-Receptor Interactions between Glomerular Endothelial Cells and Immune Cells – snRNAseq Semaglutide promotes glomerular endothelial repair and remodeling programs: Type 4 collagen, integrins, PECAM1 (CD31), CDH5 (VE cadherin) Tuttle KR, Bjornstad P… Kretzler M et al. Nat Med 2026 Oct 1. Online
Slide 52: Spatial Transcriptomics Glomerular Endothelial and Natural Killer T Cells
Spatial Transcriptomics Glomerular Endothelial and Natural Killer T Cells, Monocytes/Macrophages Tuttle KR, Bjornstad P… Kretzler M et al. Nat Med 2026 Oct 1. Online ahead of print. PMID: 42823485
Slide 53: Reduced Fractional Intimal Area of Most Diseased Arterioles
Reduced Fractional Intimal Area of Most Diseased Arterioles and Periglomerular Immune Cells Semaglutide Pre Post Tuttle KR, Bjornstad P… Kretzler M et al. Nat Med 2026 Oct 1. Online ahead of print. PMID: 42823485
Slide 54: Pathophysiological Interpretation of Semaglutide's Mechanisms-of-Action in CKD and T2D
Pathophysiological Interpretation of Semaglutide’s Mechanisms-of-Action in CKD and T2D Semaglutide Functional MRI Clinical/biochemical Endothelial measures Reduced intrarenal and Improved glomerular Attenuated metabolic and transcriptional perirenal fat hemodynamics fibro-inflammatory signaling Hist
Slide 55: ProKidney
PROKIDNEY.:::