The talk will outline the new concept of applying a 4 pillar approach in the treatment of diabetic and non-diabetic patients with kidney disease, which just became available recently. With the publication of the FLOW study on may 24 last month, the 4 foundational therapies available consist of RASi, SGLT2i, nsMRA and GLP1-RA. Despite these overwhelming advances in halting or retarding CKD progression, implementation barriers of these treatments exist. Many patients driving on the path to kidney replacement therapy will not receive these treatments. The barriers will be discussed.

Christoph Wanner is a senior professor of medicine in the Department of Clinical Studies and Epidemiology, University Hospital of Würzburg and a visiting professor of renal medicine at the Nuffield Department of Population Health, Clinical Trial Service Unit, University of Oxford.