WCN25-2926 BALANCING CARDIOVASCULAR RISK: RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM INHIBITION IN HEMODIALYSIS PATIENTS AMID POTASSIUM CHALLENGES AND HYPOTENSION RISK

Chronic kidney disease (CKD) is a significant public health issue, impacting around 850 million individuals globally(1). The prevalence of renal replacement therapy (RRT) varies widely, from 4.4 cases per million people (pmp) in Rwanda to 3,679 cases pmp in Taiwan(2). In Spain, 39.8% of patients with CKD undergoing RRT are on hemodialysis (HD)(3). Among CKD patients, cardiovascular disease (CVD) remains the leading cause of hospitalization and mortality(3,4). The hyperactivation of the renin-angiotensin-aldosterone system (RAAS)(5) is closely associated with CVD, providing a rationale for the use of RAAS inhibitors (RAASi) in association with sodium-glucose transport protein 2 inhibitors (SGLT2i) to reduce the risk of CVD and mortality(6-10).