Table 3.

Guideline-directed use of proteinuria-reducing therapies for adults with kidney disease [3,35,36,37,38]. * Non-steroidal MRA can be initiated for patients with eGFR ≥ 25 mL/min/1.73 m². ** SGLT2i can be initiated for patients with eGFR ≥ 20 mL/min/1.73 m² and continued if eGFR declines after initiation. eGFR: estimated glomerular filtration rate; GLP-1 RA: glucagon-like peptide 1 receptor agonists; MRA: mineralocorticoid receptor antagonists; RASi: renin-angiotensin-system inhibitors; SGLT2i: sodium-glucose cotransporter 2 inhibitors; T1D: type 1 diabetes; T2D: type 2 diabetes; UACR: urine albumin/creatinine ratio.

Guideline- Directed Care	Kidney Disease Improving Global Outcomes (KDIGO)	American Diabetes Association (ADA)	American College of Cardiology/American Heart Association (ACC/AHA)
RASi	People with T1D or T2D with UACR > 30–300 mg/g; Non- diabetic patients with UACR > 300 mg/g	People with T1D or T2D who have hypertension and UACR ≥ 30 mg/g	People with heart failure with reduced, preserved, or minimally reduced ejection fraction; people with chronic coronary disease
MRA	People with T2D and UACR ≥ 30 mg/g despite maximum tolerated dose of RASi *
SGLT2i	People with T2D, heart failure, or UACR >200 mg/g **	People with T2D with cardiovascular disease
GLP-1 RA	People with T2D who have not achieved glycemic targets despite use of metformin and SGLT2i		People with chronic coronary disease