Reducing the risk of hyperkalemia when using renin-angiotensin-aldosterone system blockers
| Assess renal function to define overall risk of hyperkalemia |
| Discontinue medications that can impair renal potassium excretion, including herbal preparations and over-the-counter nonsteroidal anti-inflammatory drugs |
| Reduce potassium in diet, avoid salt substitutes containing potassium |
| Ensure effective diuretic therapy (loop diuretics should be used if the estimated glomerular filtration rate is < 30 mLmin/1.73 m2) |
| Correct metabolic acidosis when present |
| Start with low doses of renin-angiotensin-aldosterone system blockers and monitor closely |