Improvements in Kidney Outcomes Over the Years: Reason for Optimism but a Challenge for Trialists

Chronic kidney disease (CKD) is common, costly, and a leading cause of preventable morbidity and premature death worldwide.1 Patients with CKD are at increased risk of progression to kidney failure and cardiovascular events. Historically, renin-angiotensin system (RAS) inhibitors and statins were the only treatments proven to reduce the risk of each of these outcomes in people with CKD.2-4 Recently, sodium glucose cotransporter-2 (SGLT2) inhibitors and nonsteroidal mineralocorticoid receptor antagonists (MRA) have been shown to substantially reduce the risk of kidney disease progression and cardiovascular events and are recommended in certain CKD populations.