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This systematic review aims to evaluate the efficacy and safety of emerging therapeutic strategies for CKD management, including sodium\u2010glucose cotransporter 2 inhibitors (SGLT2i), glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101RA), finerenone, sacubitril\/valsartan, and potassium binders. We conducted searches in databases including PubMed, Scopus, CINAHL Complete, and Web of Science Core Collection to identify experimental and observational studies pertaining to each of these agents. Included studies were those that enrolled adult patients with CKD who evaluated SGLT2i, GLP\u20101RA, finerenone, sacubitril\/valsartan, and potassium binders compared to other medications or placebo and evaluated renal\u2010related outcomes as a primary or secondary outcome. Methodological quality and risk of bias were assessed using the Cochrane Risk of Bias (version 2) tool for experimental studies and ROBINS\u2010I for observational studies. After screening 2135 unique studies, 138 studies were eligible for this review. These studies describe a substantial and growing body of evidence focused on improving the management of CKD beyond renin\u2010angiotensin system inhibitors (RASi), such as angiotensin\u2010converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs). Currently, SGLT2i have demonstrated consistent benefits with large effect sizes in preventing the progression of CKD, solidifying this class as a first\u2010line treatment along with RASi. Subsequent consideration for GLP\u20101RA, finerenone, and sacubitril\/valsartan should be dependent on patient\u2010specific comorbidities, while potassium binders may allow for longer use of RASi.<\/jats:p>","DOI":"10.1002\/phar.70014","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T19:03:35Z","timestamp":1743361415000},"page":"291-306","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Updates in chronic kidney disease management: A systematic review"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0031-5067","authenticated-orcid":false,"given":"Amina","family":"Ammar","sequence":"first","affiliation":[{"name":"Eugene Applebaum College of Pharmacy &amp; Health Sciences Wayne State University  Detroit Michigan USA"},{"name":"Department of Pharmacy Henry Ford St. John Hospital  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8175-372X","authenticated-orcid":false,"given":"Stephanie B.","family":"Edwin","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Henry Ford St. John Hospital  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9648-055X","authenticated-orcid":false,"given":"Rachel","family":"Whitney","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2658-8247","authenticated-orcid":false,"given":"Melissa","family":"Lipari","sequence":"additional","affiliation":[{"name":"Eugene Applebaum College of Pharmacy &amp; Health Sciences Wayne State University  Detroit Michigan USA"},{"name":"Department of Pharmacy Henry Ford St. John Hospital  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0540-785X","authenticated-orcid":false,"given":"Christopher","family":"Giuliano","sequence":"additional","affiliation":[{"name":"Eugene Applebaum College of Pharmacy &amp; Health Sciences Wayne State University  Detroit Michigan USA"},{"name":"Department of Pharmacy Henry Ford St. John Hospital  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30045-3"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kisu.2021.11.003"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.10.018"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2011.12.023"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2023.05.015"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pop.2008.01.008"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pop.2020.08.001"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)32064-5"},{"issue":"1","key":"e_1_2_7_10_1","first-page":"1","article-title":"Kidney disease: improving global outcomes (KDIGO) CKD work group. 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