Management of non-dialysis dependent chronic kidney disease: A practical approach for clinicians

Chronic kidney disease (CKD) affects approximately 10% of the global population and represents a major health challenge with significant cardio-vascular morbidity and mortality. This review provides an update on evidence-based management strategies for non-dialysis-dependent CKD. Key advances include the widespread adoption of sodium-glucose cotransporter-2 (SGLT2) inhibitors across the CKD spectrum, introduction of non-steroidal mineralocorticoid receptor antagonists such as finerenone, and refined approaches to CKDassociated complications, including anaemia and mineral bone disorders. Contemporary management emphasises early detection through systematic screening, aggressive cardiovascular risk modification, combination nephroprotective therapies, and timely preparation for kidney replacement therapy. The integration of novel therapeutic agents with established treatments offers unprecedented opportunities to slow disease progression and improve patient outcomes through multi-disciplinary, team-based care approaches.