Abstract
Chronic kidney disease (CKD) poses a substantial global health burden. It is classified according to estimated glomerular filtration rate (eGFR) (G1-G5) and albuminuria (A1-A3). In recent years the clinicians' therapeutic options for slowing CKD progression and mitigating cardiovascular disease has been significantly expanded:For CKD with albuminuria, concomitant cardiovascular disease or diabetes mellitus, a target blood pressure <130/80mmHg should be aspired. Apart from the geriatric population and those with a life expectancy below one year a blood pressure <140/90mmHg should be targeted. Renin-angiotensin-system inhibitors (RASi) and sodium-glucose-cotransporter 2 inhibitors (SGLT2i) are the basis of CKD therapy. SGLT2i can be prescribed in most cases of CKD with an eGFR >20ml/min/1.73m2 apart from a few exceptions. Once started, patients should stay on SGLT2i until dialysis. Finerenon is a novel option for diabetic nephropathy with an ACR >30mg/g [3mg/mmol] and an eGFR >25ml/min/1.73m2. Finerenon slows CKD progression and reduces cardiovascular events.
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