Optimization of Renin-Angiotensin-Aldosterone Inhibitor Therapies for Evidence-Based Indications: a Call to Action From the Cardio-Kidney Community

Roberto Pecoits‐Filho, Michelle Wong, Monica Moorthy, Debasish Banerjee, Suman Behera, Viviane Cálice-Silva, Mogamat‐Yazied Chothia, Gates B. Colbert, Martha Gulati, Charles A. Herzog

9 more authors

Fadi Jouhra, Edgar V. Lerma, Charu Malik, Kershaw V. Patel, Amina Rakisheva, Giuseppe M.C. Rosano, Priyanka Satish, Henry H. L. Wu, Angela Yee-Moon Wang

Kidney International Reports, 2025

Full text Open access: Gold Metadata (CSL-JSON)

DOI 10.1016/j.ekir.2025.03.036

Data confidence 85 high

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Abstract

Renin–angiotensin–aldosterone system inhibitor (RAASi) therapy, including angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARBs), angiotensin receptor-neprilysin inhibitors (ARNi), and steroidal and non-steroidal mineralocorticoid receptor antagonists (MRAs), is essential for treating diabetic and non-diabetic chronic kidney disease (CKD), heart failure (HF), and hypertension (HTN). However, these medications can lead to adverse events such as acute kidney injury and hyperkalemia.