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Editorial
. 2021 Feb 1;6(3):565-567.
doi: 10.1016/j.ekir.2021.01.016. eCollection 2021 Mar.

Recent International Progress in Preventive Nephrology and the Road Less Traveled Ahead

Joseph A Vassalotti  1   2
Affiliations
Editorial

Recent International Progress in Preventive Nephrology and the Road Less Traveled Ahead

Joseph A Vassalotti. Kidney Int Rep. .
No abstract available

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Figures

Figure 1
Figure 1
Interventions to slow CKD progression and/or reduce cardiovascular risk. aUnclear if and when to discontinue RAS inhibition in advanced CKD. bStatins should not be initiated for those beginning dialysis therapy. However, patients already receiving statins at the time of dialysis initiation can continue their statin treatment. cApplies to CKD patients with type 2 diabetes only. SGLT2 inhibitor is recommended as first-line treatment with metformin and may also have benefits in those with CKD and no diabetes. SGLT2 inhibitors should be initiated if eGFR is 30 ml/min per 1.73 m2 and can be continued through G4–G5 until initiation of dialysis, at which point the SGLT2 inhibitor should be discontinued. There is no evidence for initiation of SGLT2 inhibitors if eGFR <30 ml/min per 1.73 m2. dApplies to CKD patients with type 2 diabetes only. GLP-1 receptor agonist can be considered when SGLT2 inhibitor and/or metformin is not tolerated or glycemic target is not reached. Dulaglutide can be used if eGFR is >15 ml/min per 1.73 m2; exenatide can be used if creatinine clearance is >30 ml/min; there are limited data for use of liraglutide, lixisenatide, or semaglutide in severe CKD. Consult dosing recommendations for use of these agents in CKD G4 and G5. CKD, chronic kidney disease; estimated glomerular filtration rate; GLP-1, glucagon-like peptide-1; RAS, renin‒angiotensin system; SGLT2, sodium-glucose cotransporter-2. Reproduced with permission from Shlipak et al.
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Comment on

References

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