Chronic kidney disease (CKD) progression follows a heterogeneous course, with a minority of individuals reaching kidney failure.1 When recognized early, progression in high-risk individuals can be reduced by managing upstream risk factors using disease-modifying medications, managing blood pressure (BP), and achieving adequate glycemic control.2 If treatment is delayed until nephrology referral, the therapeutic window for several disease-modifying drugs is narrowed or closed, and kidney failure can only be delayed, not prevented.