albuminuria), Stage 4Kb (severely increased persistent albuminuria), and stage 5Ka (eGFR < 45 mL/min/1. 73m2) were evaluated. The rate of RASi, SGLT2i, GLP-1 RA, and finerenone together with metabolic attainment targets were evaluated prospectively from year 2021 to 2025. Results: A total of 206 medical records were reviewed (mean age 64. 110. 3years, A1C 7. 31. 2%, mean eGFR 71. 624. 5 mL/min/ 1. 73 m2). In 2021, the rate of RASi was 78. 2%, SGLT2i in 51. 5%, GLP-1 RA in 13. 6% of all patients. At 4 years later, the rate of GDMT were improved as follows: RASi 79. 7%, %, SGLT2i 59. 3%, GLP-1 RA 19. 8%, finerenone 2. 8%. However, only 1. 1% of all patients in 2025 received all 4 GDMT items. More stabilized or improved TDS patients were found in patients who received GDMT 3 classes from all 4 medication classes when compared with patients who received GDMT < 3 classes (96. 2% vs. 78. 8%, P-value = 0. 036). Conclusion: The real-world implementation of GDMT among DKD patients were still inadequate and more efforts are required to improve GDMT uptake. Regularly reviews and feedbacks are warranted to improve treatment target attainments and outcomes. I have no potential conflict of interest to disclose. I did not use generative AI and AI-assisted technologies in the writing process.
Shimada et al. (Wed,) studied this question.