This chapter distills landmark nephrology trials that reshaped everyday practice across diabetic kidney disease, CKD lipid therapy, anemia management, mineral bone disorder, iron strategy, dialysis timing, and resistant hypertension. RENAAL established ARBs as kidney-protective in type 2 diabetic nephropathy by slowing progression to ESRD. TEMPO 3:4 demonstrated that tolvaptan slows kidney growth and functional decline in ADPKD, introducing the first disease-modifying therapy for rapid progressors. SHARP confirmed that LDL lowering with simvastatin plus ezetimibe reduces major atherosclerotic events in CKD, whereas AURORA showed no cardiovascular benefit of statins once patients are on maintenance hemodialysis. CHOIR cautioned against high hemoglobin targets with ESAs due to increased cardiovascular harm without quality-of-life gain. EVOLVE offered mixed cardiovascular signals for cinacalcet but reduced parathyroidectomy, informing selective use in dialysis patients with secondary hyperparathyroidism. PIVOTAL supported proactive, higher-dose IV iron to cut cardiovascular events and lower ESA needs without increasing infections. IDEAL showed that starting dialysis based on symptoms and complications, not eGFR alone, is safe and appropriate. PATHWAY-2 identified spironolactone as the most effective fourth-line agent for resistant hypertension. CREDENCE established SGLT2 inhibitors as foundational reno- and cardioprotective therapy in diabetic CKD on top of RAAS blockade. Together, these studies anchor guideline-driven, patient-centered care throughout the CKD continuum.