The Advancements of Renin-Angiotensin-Aldosterone System Inhibitor (RAASi) Therapy in Chronic Diseases
Chronic kidney disease and heart failure are just two of the many diseases that have shown significant improvement due to advancements in Renin-Angiotensin-Aldosterone System Inhibitor (RAASi) therapy. Recent studies have demonstrated the potential of RAASi therapy to slow disease progression and improve survival rates, especially in diabetic kidney disease. Dr. Kam Kalantar-Zadeh, MD, MPH, PhD, chief of the Division of Nephrology, Hypertension, and Transplantation at the University of California Irvine Medical Center, discussed this progress during an interview with HCPLive.
During his session at the National Kidney Foundation (NKF) 2024 Spring Clinical Meeting, Kalantar-Zadeh highlighted dietary challenges, potassium control, and potential solutions related to RAASi therapy. The session aimed to offer valuable insights to healthcare providers across various disciplines to enhance patient care and outcomes in clinical practice through engaging discussions and knowledge exchange. Two out of the four guideline-directed medical therapy (GDMT) classes for chronic kidney disease management in diabetes involve RAASis, underscoring their significance in treatment. Despite challenges like hyperkalemia, Kalantar-Zadeh stresses the importance of not abandoning the prescribed RAASi dose. He advocates for multidisciplinary collaboration to explore solutions like dietary modifications and potassium-binding therapies to address these challenges.
Studies such as FIDELIO have shown promising outcomes in managing diabetic kidney disease with RAASi therapy, although there is a risk of hyperkalemia. This risk can be mitigated by effective potassium control strategies using specialized binders. Therefore, further research is needed to optimize RAASi dosing and explore the use of potassium binding therapy to allow patients to tolerate and maximize the dose of RAASi while maintaining quality of life and fewer dietary restrictions. It’s worth noting that Dr. Kalantar-Zadeh discloses sporadic consulting for Vifor Pharma.
In conclusion, RAASi therapy has shown significant impact on various disease groups