Transformative global models for CKD care: case studies and strategies

Chronic kidney disease (CKD) affects approximately 10% of adults worldwide and is associated with an elevated risk of cardiovascular disease, such as heart failure, and increased prevalence of comorbidities such as type 2 diabetes. Early CKD diagnosis and intervention are crucial to prevent progression to advanced kidney disease, which imposes a significant clinical and economic burden on health systems and patients alike. Despite the availability of global CKD management guidelines, adherence remains low, particularly with respect to the use of sodium-glucose cotransporter 2 inhibitors (SGLT2is), which offer strong cardiorenal benefits particularly when initiated in a timely manner. This gap underscores the urgent need for practical solutions to translate existing guideline recommendations into improved clinical practice across the CKD management pathway, encompassing screening, treatment initiation and referral. This manuscript highlights successful global initiatives in CKD management, presenting a 'call-to-action' to support healthcare systems and providers in achieving improved CKD management worldwide. By bringing together eight diverse 'Champions of Change' initiatives from various health systems, this paper presents innovative and transformative solutions across the entire CKD management pathway, from early diagnosis to treatment. These case studies underscore the potential of tailored, context-specific strategies for transforming CKD care. By adopting core principles such as proactive screening, risk stratification strategies, multidisciplinary collaboration, knowledge-sharing and patient-centred approaches, healthcare systems and providers can adapt these successful models to their local settings, thereby advancing global efforts to prevent CKD progression and improve patient outcomes.