What should be done before starting GDMT in patients with established renal disease?
Caution should be taken when starting GDMT in patients with established renal disease. Renal function and potassium should be assessed within 1 to 2 weeks after initiation or dose increase of an ARNI/ACEI/ARB. In patients with preserved renal function or mild to moderate renal impairment, renal function and potassium after initiation and titration of aldosterone antagonists should be assessed within 2 to 3 days and again at 7 days.