Use of Pragmatic Trials to Improve Implementation of Best Practices for CKD

During the last several years, multiple treatments including sodium/glucose cotransporter 2 inhibitors, mineralocorticoid receptor antagonists, and glucagon-like peptide-1 receptor agonists have been shown in randomized clinical trials to slow the progression of chronic kidney disease (CKD), reduce cardiovascular events, and improve survival in people with diabetes mellitus. Importantly, for some of these medications, evidence is accumulating suggesting benefits for nondiabetic CKD as well. Excitement about the potential for these treatments and others to improve outcomes for millions of people with CKD is palpable within the nephrology community.