What Usain Bolt's Jardiance Commercial Can Teach Us About CKD
Usain Bolt built his entire identity on speed. In 2009, he
covered 100 meters in 9.58 seconds, a world record that still stands nearly two
decades later. He is, by any measure, the fastest human being who has ever
lived. So it's a little disorienting to see him on American television these
days, not sprinting, but talking about the value of slowing down.
The commercial is for Jardiance, called "Slow Can Be
Good Too," and it deliberately turns Bolt's public identity upside
down. Speed made him famous. But the ad isn't selling speed. It's making the
case that slowing something down, specifically the progression of a chronic
disease, can be its own kind of victory. That contrast is what makes the
advertising work. Our brains are wired to notice contradictions, and pairing
the world's fastest man with a message about deceleration creates exactly the
kind of cognitive friction that makes people pay attention.
Buried inside the ad is a simple line that matters far more
than the celebrity casting: "When was the last time you had your
kidneys checked?" That question is worth pausing on, because most
people genuinely don't know the answer.
The Commercial Contains a More Important Message
It's tempting to read the ad as just another celebrity
pharmaceutical spot. But the word that matters here isn't Jardiance. It's
progression. Chronic kidney disease, or CKD, is a condition that typically
develops slowly, often over years, and it rarely announces itself with dramatic
symptoms in its earlier stages. A person can lose a meaningful share of kidney
function and feel completely normal.
That quiet progression is precisely why CKD is such an
underrecognized problem. According to the Centers for Disease Control and
Prevention's most recent national estimates, roughly 14 percent of U.S. adults,
or about 37 million people, have chronic kidney disease [1]. Far more striking
is how many of them don't know it. The CDC has found that about 9 in 10 adults
with CKD are unaware they have it [1]. That is not a small awareness gap. It is
nearly the entire affected population moving through the disease without a
diagnosis, often until it has advanced considerably.
What Exactly Is CKD?
Think of the kidneys as filters. Roughly the size of fists,
sitting toward the back of the abdomen, they filter waste and excess fluid out
of the blood, help regulate blood pressure, and keep the body's chemistry in
balance. Chronic kidney disease means that filtering ability has been damaged
and is diminished, and that the damage has persisted for at least three months.
CKD is typically staged using two pieces of information
rather than one, which is part of why it's harder to explain than, say, a
cholesterol number. As kidney function declines, the body loses its ability to
clear waste products and regulate fluid balance, which over time raises the
risk of cardiovascular disease, anemia, bone problems, and eventually kidney
failure requiring dialysis or transplantation. The disease doesn't move in a
straight line for everyone, but for many people it is progressive, meaning it
tends to move in one direction without intervention.
The Diabetes Connection
Type 2 diabetes is the single biggest driver of CKD in
the United States, and the relationship between the two is well established.
Persistently elevated blood glucose damages the small blood vessels inside the
kidneys' filtering units over time, gradually reducing their ability to do
their job. The CDC's newest national data illustrate just how tightly linked
these conditions are: an estimated 38 percent of adults with diabetes and 21
percent of adults with high blood pressure were estimated to have CKD [1]. Even
among people with prediabetes, more than 1 in 10 were estimated to have CKD
already [1].
This is where A1C, the blood test that reflects average
blood sugar over roughly the previous three months, enters the picture. A1C
doesn't measure kidney function directly, but it is one of the best available
signals of the metabolic stress that, over years, can damage the kidneys.
Managing blood sugar isn't just about avoiding diabetes complications in the
abstract. It's directly tied to kidney protection.
Do You Know Your Numbers?
This is the practical heart of the matter, and it's worth
being specific about three separate numbers, because they measure different
things and people often conflate them.
A1C reflects longer-term blood glucose control and is
used to screen for and monitor diabetes and prediabetes.
eGFR, or estimated glomerular filtration rate, is
calculated from a blood creatinine measurement and estimates how efficiently
the kidneys are filtering blood. A lower eGFR generally indicates reduced
kidney function.
uACR, the urine albumin-to-creatinine ratio, looks
for albumin, a protein, leaking into the urine. Healthy kidneys generally keep
albumin in the blood rather than letting it pass into urine, so its presence
can be an early sign of kidney damage, sometimes appearing before eGFR changes
at all.
Current clinical guidance reflects how important it is to
check both eGFR and uACR together rather than relying on either alone. The
American Diabetes Association's 2026 Standards of Care recommend assessing
kidney function with both a random urine albumin-to-creatinine ratio and
estimated glomerular filtration rate at least annually in people with type 1
diabetes of five or more years' duration, and in all people with type 2
diabetes regardless of treatment [2]. The rationale is straightforward: albuminuria
and eGFR each carry independent information about risk, and at any given eGFR,
the degree of albuminuria is associated with the risk of cardiovascular
disease, CKD progression, and death [2].
So three questions worth bringing to your next checkup: Do
you know your A1C? Do you know your eGFR? Have you had a urine albumin test?
For most adults without diabetes or hypertension, routine kidney screening
isn't automatically part of an annual physical, so this is a conversation to
have directly with a clinician, especially for anyone with diabetes, high blood
pressure, cardiovascular disease, or a family history of kidney disease.
What Jardiance Actually Has to Do With It
Jardiance, known generically as empagliflozin, belongs to a
drug class called SGLT2 inhibitors. It was originally approved for type 2
diabetes and later for certain forms of heart failure. In September 2023, the
FDA expanded its approval again, this time specifically to reduce the risk of
sustained decline in eGFR, end-stage kidney disease, cardiovascular death, and
hospitalization in adults with chronic kidney disease at risk of progression
[3]. That approval was based on the EMPA-KIDNEY trial, a large, dedicated CKD
study in which empagliflozin reduced the composite risk of kidney disease
progression or cardiovascular death by 28 percent relative to placebo [4].
It's worth being precise about what that means. Jardiance is
not a treatment for everyone with CKD, and it isn't a substitute for blood
pressure control, glucose management, or other standard therapies. The
manufacturer notes it is not recommended for CKD in patients with polycystic
kidney disease or those requiring significant immunosuppressive therapy for
kidney disease [5], since it isn't expected to help those populations. Like any
prescription medicine, it carries its own risks and side effects, including
dehydration and genital or urinary tract infections, and whether it's
appropriate is a decision for a patient and their physician, not a conclusion
to draw from a 30-second ad.
Back to Bolt
For most of his career, Usain Bolt spent every fraction of a
second trying to go faster. His latest television role asks viewers to consider
the opposite proposition: that sometimes slowing something down is itself a
form of winning. Perhaps the most useful thing about the commercial isn't the
drug being advertised at all. It's the question it leaves behind, the one easy
to overlook amid the celebrity wattage: Do you know how well your kidneys are
working? For nearly 9 in 10 people currently living with CKD, the honest answer
is still no. That's the number worth changing.
Notes
1. Centers
for Disease Control and Prevention. Chronic Kidney Disease in the United
States (updated March 2026). CS 363495-A.
2. American
Diabetes Association. 11. Chronic Kidney Disease and Risk Management:
Standards of Care in Diabetes—2026. Diabetes Care, 2026.
3. U.S.
Food and Drug Administration approval announcement, via Eli Lilly and Company /
Boehringer Ingelheim, "US FDA approves Jardiance for the treatment of
adults with chronic kidney disease," September 22, 2023.
4. Pharmacy
Times. "FDA Approves Empagliflozin for Adults With Chronic Kidney Disease
at Risk of Progression."
5. Eli
Lilly and Company. "US FDA approves Jardiance for the treatment of adults
with chronic kidney disease" (full release, contraindication details),
September 22, 2023.
6. American
Diabetes Association Professional Practice Committee. Screening for Chronic
Kidney Disease in People with Diabetes (visual guide), April 2026.
7. National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Kidney
Disease Statistics for the United States.
8. KDIGO.
2026 Clinical Practice Guideline for Diabetes and CKD (public review
draft, March 2026).
9. HCPLive.
"Empagliflozin (Jardiance) Receives CKD Approval from US FDA."
10.Boehringer Ingelheim / Eli Lilly patient prescribing information, Jardiance Chronic Kidney Disease page.
