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foreign pillars of therapy for heart failure we just saw and with regards to Mrs and RNA very small proportion of patients tends to develop hyperkalemia when we put these patients on RNA and mras so what would be your strategies should we reduce the dose and stop RNA and MRI R should be we don't want to take this drug out of the prescription we continue these drugs and add a potassium binder so that the patient derives the best benefit out of these drugs because there are few papers on patiroma and sodium zirconium glycoslicate so these these potassium binders are now ah they seem to be safe do we put them on long-term potassium binders and just keep continuing Army and Mrs see there are two issues here I think one uh the problem of hyperkalemia is more pronounced when the patient is clinically very stable I think when you have patients on good dose of diuretics a lot of time most of these patients tolerate a combination of MRI when it becomes reasonably stable and we have the borderl...
