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Diabetes in CKD: Visual Guidelines |
Practice Point 1.2.8:
Mineralocorticoid receptor antagonists are effective for the management of refractory hypertension but may cause hyperkalemia or a reversible decline in glomerular filtration, particularly among patients with a low eGFR.
The published results from FIDELIO and forthcoming data from FIGARO trial will be formally assessed in the next guideline update.
Practice Point 1.2.4:
Advise contraception in women who are receiving ACEi or ARB therapy and discontinue these agents in women who are considering pregnancy or who become pregnant.
Practice Point 1.2.7:
Use only one agent at a time to block the RAS. The combination of an ACEi with an ARB, or the combination of an ACEi or ARB with a direct renin inhibitor, is potentially harmful.
Practice Point 1.2.6:
Reduce the dose or discontinue ACEi or ARB therapy in the setting of either symptomatic hypotension or uncontrolled hyperkalemia despite the medical treatment outlined in
Practice Point 1.2.5., or to reduce uremic symptoms while treating kidney failure (estimated glomerular filtration rate [eGFR] <15 mL/min/1.73 m²).