In this cluster randomized clinical trial that included 1596 patients with chronic kidney disease with high risk of progression to kidney failure who were not seeing a nephrologist, a multifaceted intervention vs usual care control did not reduce risk of CKD progression, but rather increased exposure to angiotensin-converting enzyme inhibitors/angiotensin 2 receptor blockers over a median follow-up of 17 months. The gene discussed is AGTR2; the disease is kidney failure.