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● Angiotensin converting enzyme inhibitors as well as angiotensin and mineralocorticoid receptor antagonists are prokalemic and they also speed up the progression of renal failure. Therefore, renal function should be estimated and potassium measured every 6 months, and more frequently at decompensation, onset of new co-morbidities, or at therapy adjustment. The aforementioned drugs need to be dose-reduced or even discontinued at advanced renal failure.
● Blood pressure and pulse (if needed, the latter one supplemented by ECG) will help to detect other common treatment-related side-effects such as hypotension, bradycardia, or bradyarrhythmia. These side-effects may also require such dose reduction or even drug discontinuation.
● Patients should be encouraged to record weight and report short-term increases (e.g. >2.5 kg/week) which frequently indicate cardiac decompensation.