TABLE 3.
Recommendations for the use of RAAS inhibitors for management of BP in CKD as per KDIGO and NICE.
| Diabetes | Recommendations (KDIGO and NICE) | |||||
|---|---|---|---|---|---|---|
| DRI | ACEIs | ARBs | Albuminuria | Applicable for CKD patients that receive dialysis or a kidney transplant | Strength of recommendation | |
| No | Not provided | Start | Start | Severely increased (G1–G4 and A3) | No | Strong |
| No | Not provided | Start | Start | Modestly elevated albuminuria (G1–G4 and A2) | No | Weak |
| Yes | Not provided | Start | Start | Modestly to severely elevated albuminuria (G1–G4, A2, and A3 | No | Strong |
| No | — | — | Start | — | Kidney transplant | Strong |
KDIGO recommends avoiding any combination of ACEI, ARB, and DRI therapy in diabetic and non-diabetic CKD patients. NICE recommends not offering RAAS inhibitors to CKD patients with a pretreatment serum K+ level of >5.0 mmol/L and discontinuing them when serum K+ reaches ≥6.0 mmol/L in patients.