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Do you stop ACEi or ARB medications in patients with ESKD who are on hemodialysis and have issues with chronic hyperkalemia?

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Mednet Member
Mednet Member
Nephrology · University Of California San Francisco Medical Center At Parnassus

I don't. I don't think it contributes much to the hyperkalemia. I usually try to correct the potassium using modifications of the potassium bath, dietary changes and if still high potassium binders.

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Mednet Member
Mednet Member
Nephrology · NYU Grossman Long Island School of Medicine

I try not to, given the beneficial cardiovascular effects, and I add potassium binders and dietary modifications. However, hyperkalemia does increase mortality in ESRD patients, so if the potassium remains high despite these interventions, I will stop the ACEi or ARB. The data are mixed, as far as I...

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