ACE and Hyperkalemia: Of note, the risk for hyperkalemia is further enhanced under specific conditions, such as metabolic acidosis, reduction in GFR, or use of drugs inhibiting renal tubular potassium excretion [i.e., angiotensin converting enzyme (ACE) inhibitors, angiotensin II (Ang II) type 1 (AT1) receptor antagonists, MR antagonists, non-steroidal anti-inflammatory drugs (43)].