Pre-dialysis care in particular is crucial for individuals with CKD to prevent or delay the progression of CKD to kidney failure, particularly in this era of new disease-modifying treatments including the ‘four pillars’ – sodium glucose co-transporter 2 inhibitors, glucagon-like peptide-1 receptor agonists, and the non-steroidal mineralocorticoid receptor antagonist finerenone, along with pre-existing angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers [21]. The gene discussed is ACE; the disease is kidney failure.