What is the recommendation of the Work Group regarding dual RASi therapy for patients with CKD with or without diabetes?
The Work Group recommends that dual therapy should be discouraged for patients with CKD with or without diabetes, with or without albuminuria. This recommendation is based on the fact that dual therapies of RASi have not been conclusively found to be beneficial compared to monotherapies, and that there is a higher risk of hyperkalemia when an MRA is added to an ACEi or ARB for renoprotection in these patients. Additionally, the associated risks of hyperkalemia and AKI, as well as the need for more frequent laboratory tests, office and emergency department visits, additional short-term therapies, and adjustment in diet make dual therapy an undesirable treatment option for these patients.