Should RAAS blockade therapy be continued in patients with advanced renal disease?

Probably. Renin-angiotensin-aldosterone system (RAAS) blockade therapy should be continued in most patients with advanced renal disease and comorbid conditions; however, individualized treatment is warranted as data on the benefits and harms in all-cause mortality, cardiovascular mortality, and risk for renal replacement therapy are inconclusive (strength of recommendation [SOR]: B, based on observational studies, systematic reviews, and meta-analyses of randomized controlled trials [RCTs]). Certain patient populations, such as patients with diabetes or those with cardiovascular risk or history, may benefit most from continued RAAS blockade therapy (SOR: A, based on systematic reviews and meta-analyses of RCTs).