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Specifically, the composite kidney outcome had a risk ratio of 0.79 (95%CI: 0.66-0.95), and the eGFR slope showed a reduction of 0.78 mL/minute/1.73 m 2 /year (95%CI: 0.57-0.98), with no significant heterogeneity observed ( P -heterogeneity = 0.53 and 0.94, respectively)

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It independently reduces proteinuria beyond ACEi/ARB impact, with early use yielding faster outcomes, supporting evidence-based practice