A review of the recent clinical studies on the treatment of patients with the chronic kidney disease et advanced stages

Advanced chronic kidney disease is an urgent medical and social problem associated with a high risk of death, a decrease in the quality of life, and a significant financial burden on the health care system. Despite the expansion of the therapeutic arsenal and the emergence of new nephroprotective drugs, issues related to optimizing drug and replacement therapy in this category of patients remain relevant. Objective. To analyze and systematize modern therapeutic strategies aimed at slowing the progression of chronic kidney disease. Materials and methods. The study analyzed clinical data published from 2019 to the present. The data were searched in the PubMed, Scopus, Web of Science, and eLIBRARY databases. Studies with a small sample size and low-quality evidence were excluded. Results. Renin-angiotensin system inhibitors have been shown to reduce the risk of end-stage renal disease. The combined use of mineralocorticoid receptor antagonists and sodium-glucose cotransporter type 2 inhibitors further enhances nephroprotection, particularly in patients with type 2 diabetes. Glucagon-like peptide-1 receptor agonists further reduce the risk of renal and cardiovascular complications. Current approaches to treating anemia using prolyl hydroxylase inhibitors are comparable in efficacy to traditional erythropoiesis-stimulating agents. Conclusion. Modern nephroprotective agents, individualized treatment of complications, and a reasonable choice of replacement therapy slow the disease progression and improve clinical outcomes.