Profesor Invitado: Dr. Juan Carlos Ramírez Sandoval
Especialista en Nefrología

Objetivo de Aprendizaje:

• Reconocer el impacto de la hipercalemia en la optimización de terapias cardio-renales, particularmente en pacientes con insuficiencia cardiaca y enfermedad renal crónica.

• Comprender las consecuencias clínicas de la reducción o suspensión de iSRAA, incluyendo el aumento del riesgo cardiovascular, progresión de ERC y mortalidad.

• Identificar la importancia de un manejo proactivo del potasio y del abordaje interdisciplinario cardio-renal para optimizar tratamientos y mejorar los resultados clínicos.

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Referencias:

1. Frankel AH, et al. Overcoming Hyperkalaemia as a Barrier to Achieving Optimal RAASi Therapy and Cardiorenal Protection in Individuals with Cardiorenal Disease: A Podcast Discussion. Adv Ther. 2026. 
2. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4):S117-S314. 
3. McDonagh TA, et al. 2021 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure. Europ Heart J. 2021;42(36):3599-3726.  
4. Jafar TH. Angiotensin-Converting Enzyme Inhibitors and Progression of Nondiabetic Renal Disease. Ann Int Med. 2001;135(2):73. 
5. Xie X, et al. Renin-Angiotensin System Inhibitors and Kidney and Cardiovascular Outcomes in Patients With CKD: A Bayesian Network Meta-analysis of Randomized Clinical Trials. AJKD. 2016;67(5):728-741.  
6. Werner C, et al. RAS blockade with ARB and ACE inhibitors: current perspective on rationale and patient selection’, Clin Res Cardiol. 2016;97(7):418-431.  
7. Rosano GMC, et al. Expert consensus document on the management of hyperkalaemia in patients with cardiovascular disease treated with renin angiotensin aldosterone system inhibitors: coordinated by the Working Group on Cardiovascular Pharmacotherapy of the European Society of Cardiology. Eur Heart J Cardiovasc Pharmacother. 2018;4(3):180-188. 
8. Burton JO, et al. An international Delphi consensus regarding best practice recommendations for hyperkalaemia across the cardiorenal spectrum. Eur J Heart Fail. 2022;24(9):1467-1477. 
9. Maggioni AP, et al. Heart Failure Association of the ESC. Are hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines? Evidence from 12440 patients of the ESC Heart Failure Long-Term Registry. Eur J Heart Fail. 2013;15:1173-1184. 
10. Epstein M, et al. Evaluation of the treatment gap between clinical guidelines and the utilization of renin-angiotensin-aldosterone system inhibitors. Am J Manag Care. 2015;21(11 Suppl):S212-S220. 
11. Chen IW, et al. Discontinuation versus continuation of renin-angiotensin system inhibitors in chronic kidney disease stage 3-5 patients: a systematic review and meta-analysis. Front Pharmacol. 2025;16:1646969.