A man with HFrEF takes sacubitril/valsartan, bisoprolol and dapagliflozin. eGFR is 42 mL/min/1.73 m² and potassium is 5.2 mmol/L on two

Question

A man with HFrEF takes sacubitril/valsartan, bisoprolol and dapagliflozin. eGFR is 42 mL/min/1.73 m² and potassium is 5.2 mmol/L on two non-haemolysed samples. He is euvolaemic. Which is the best next step when considering an MRA?

Accepted Answer

Correct potassium before carefully introducing an MRA

Answer

Replace dapagliflozin with bendroflumethiazide solely to lower potassium

Answer

Accept potassium up to 6.5 mmol/L before monitoring

Answer

Withhold all renin–angiotensin system treatment permanently

Answer

Start spironolactone 25 mg immediately without further action

HFrEF — EECC MCQ

A man with HFrEF takes sacubitril/valsartan, bisoprolol and dapagliflozin. eGFR is 42 mL/min/1.73 m² and potassium is 5.2 mmol/L on two non-haemolysed samples. He is euvolaemic. Which is the best next step when considering an MRA?