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The text discusses the issue of hyperkalemia in heart failure patients on RNA and MRAs. A small proportion of patients develop hyperkalemia when on these medications. Strategies include reducing the dose, adding a potassium binder, and not removing the drugs from the prescription. Potassium binders like patiromer and sodium zirconium glycosilate are considered safe for long-term use. Hyperkalemia is more of a concern in clinically stable patients on diuretics, but most patients can tolerate a combination of MRAs when stable.
