{"references": ["Vol. 180. N\u00ba 5. p\u00e1gs 718-726. 2020. Qiao Y, Shin J-I, Chen TK, et al. Association between reninangiotensin system blockade discontinuation and all-cause mortality among persons with low estimated glomerular filtration rate. JAMA Intern Med. https://doi:10.1001/jamainternmed.2020.0193", "Vol. 21 N\u00ba 11. (suppl): S212-S220. 2015. Epstein M, Reaven N, Funk S, McGaughey K, Oestreicher N, Knispel J. Evaluation of the treatment gap between clinical guidelines and the utilization of renin-angiotensin-aldosterone system inhibitors. Am J Manag Care.", "Vol 8. N\u00ba 22. 2019. Cecilia Linde, Ameet Bakhai, Hans Furuland, Marc Evans, Phil McEwan, Daniel Ayoubkhani, Lei Qin. Real\u2010World Associations of Renin\u2013Angiotensin\u2013Aldosterone System Inhibitor Dose, Hyperkalemia, and Adverse Clinical Outcomes in a Cohort of Patients With New\u2010Onset Chronic Kidney Disease or Heart Failure in the United Kingdom. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.119.012655", "Vol 34, N\u00ba 9; pags. 1095-1099. 2012. Tolga Yildirim, Mustafa Arici, Serhan Piskinpasa, Aysun Aybal-Kutlugun, Rahmi Yilmaz, Bulent Altun, Yunus Erdem, Cetin TurganMajor barriers against renin-angiotensin-aldosterone system blocker use in chronic kidney disease stages 3-5 in clinical practice: a safety concern?. Renal Failure. https://doi.org/10.3109/0886022X.2012.717478", "Vol 24. N\u00ba 9; pags. 1467-1477. 2022. James O. Burton, Andrew J.S. Coats, Csaba P. Kovesdy, Biff F. Palmer, Ileana L. Pi\u00f1a, Giuseppe Rosano, Manish M. Sood, Shelley Zieroth. An international Delphi consensus regarding best practice recommendations for hyperkalaemia across the cardiorenal spectrum. European Journal of Heart Failure. https://doi.org/10.1002/ejhf.2612", "Vol 9. N\u00ba 5; pags. 3071-3078. Alberto Esteban-Fern\u00e1ndez, Carolina Ortiz Cort\u00e9s, Silvia L\u00f3pez-Fern\u00e1ndez, Alejandro Recio Mayoral, Francisco Javier Camacho Jurado, In\u00e9s G\u00f3mez Otero, Mar\u00eda Molina. Experience with the potassium binder patiromer in hyperkalaemia management in heart failure patients in real life. ESC Heart Failure. https://doi.org/10.1002/ehf2.13976"]}

Está establecido que el tratamiento con inhibidores del sistema renina-angiotensina-aldosterona (RAASi) en pacientes con enfermedad renal crónica (ERC) enlentece la evolución de la enfermedad. Sin embargo, es frecuente la aparición de hiperpotasemia. Esto coloca al clínico en el dilema de suspender o mantener el tratamiento. Recientes estudios abogan por buscar estrategias para mantener el tratamiento a dosis plenas, dado su beneficio en la morbimortalidad. It is established that treatment with renin-angiotensin-aldosterone system inhibitors (RAASi) in patients with chronic kidney disease (CKD) slows down the progression of the disease. However, hyperkalemia is common. This places the clinician in the dilemma of suspending or maintaining treatment. Recent studies advocate seeking strategies to maintain treatment at full doses, given its benefit in morbidity and mortality.