Implementation, not hesitation, for SGLT2 inhibition as foundational therapy for chronic kidney disease

Despite the increasing burden of ill health attributable to chronic kidney disease, appropriate pharmacotherapy has been inadequate. Based on trials in the 1990s and 2000s,1 guidelines recommend renin angiotensin system (RAS) inhibition to reduce progression of chronic kidney disease and its associated cardiovascular risk. However, the global burden of chronic kidney disease continues to increase.1 Furthermore, data from the US CURE-CKD registry highlights that uptake of chronic kidney disease management strategies is low, with only around 21% of patients prescribed RAS inhibitors between 2006 and 2017.