What is the committee's guidance regarding the use of ACE-I, ARB and MRA in patients with CKD where renal function is declining?
The committee reported a lack of clarity about using ACE-I, ARB and MRA in patients with CKD where renal function is declining. They discussed that in these circumstances, total cessation of these medications may deprive patients of the beneficial effects on morbidity and mortality. Therefore, modification to the doses of these agents, or even temporary cessation of one or more agents, should be made based on individual patient circumstances, and guidance from renal physicians should be considered where necessary.