Practice Points Serum potassium levels and eGFR should be monitored within 2 to 4 weeks after initiating an ACE inhibitor, an ARB, an SGLT2i, finerenone, or with changes in these medications. Finerenone can be used for persistent albuminuria in addition to an ACE inhibitor or an ARB and SGLT2i, or in people with CKD in DM who cannot take an SGLT2i. In the absence of albuminuria and with normal BP, ACE inhibitors or ARBs do not prevent DKD onset. ACE inhibitors and ARBs should not be used together due to increased risks of adverse effects, particularly hyperkalemia and AKI. ACE inhibitors and ARBs are not safe for use in pregnant women.