What is the rationale for recommending RASi treatment for patients with CKD G3 G4, A3 without diabetes?
We make this recommendation for RASi because the benefits of kidney and CV protection outweigh the potential adverse risks; therefore, most well-informed patients with CKD not on dialysis with severely increased albuminuria but without diabetes will opt for treatment with RASi. We feel that patients put a large value on the cardio- and renoprotective benefits of RASi and are willing to tolerate its potential harms, including hyperkalemia and AKI. These side effects, however, may lead to higher healthcare costs from additional visits and laboratory testing.